MEDICARE: JUNI HEALTH CLINIC LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	111N00000X	Chiropractor	CHIR007440	GA

General Provider Information

NPI Number	:	1164668919
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	JUNI HEALTH CLINIC LLC

Provider Business Mailing Address
First Line	:	1630 PLEASANT HILL RD
Second Line	:	#230
City	:	DULUTH
State	:	GA
Zip	:	30096-8839
Country	:	US
Telephone Number	:	678-924-3434
Fax Number	:	678-924-3432

Provider Business Practice Location Address
First Line	:	1630 PLEASANT HILL RD
Second Line	:	#230
City	:	DULUTH
State	:	GA
Zip	:	30096-5899
Country	:	US
Telephone Number	:	678-924-3434
Fax Number	:	678-924-3432

Authorized Official
Title or Position	:	DOCTOR/OWNER
Name	:	DR. JAE MIN PARK
Credential	:	D.C.
Telephone Number	:	678-924-3434

Provider Enumeration Date	:	12/29/2008
Last Update Date	:	05/12/2015

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Directions to “JUNI HEALTH CLINIC LLC ” Practice Location

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