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General NPI Number Information
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NPI Number | 1982486122
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Entity Type | Organization
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Legal Business Name | PEACHTREE WELLNESS GROUP LLC
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Dates
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Enumeration Date | 10/20/2023
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Last Update Date | 07/29/2025
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Provider Practice Location Address
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Address Line | 1300 PEACHTREE INDUSTRIAL BLVD STE 4108
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City | SUWANEE
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State | GA
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Zip | 30024-4541
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Country | US
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Telephone | 470-238-3683
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Fax |
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Provider Business Mailing Address
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Address Line | 1300 PEACHTREE INDUSTRIAL BLVD STE 4108
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City | SUWANEE
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State | GA
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Zip | 30024-4541
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | CHIEF CLINICAL DIRECTOR
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Name | TONY CHUNG
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Credential |
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Telephone | 470-238-3683
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 171100000X
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Taxonomy Name | Acupuncturist
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number |
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License Number State |
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