MEDICARE: JK HEALTH CARE GROUP, INC

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	CHIR007922	GA

General Provider Information

NPI Number	:	1366794786
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	JK HEALTH CARE GROUP, INC

Provider Business Mailing Address
First Line	:	3775 VENTURE DR
Second Line	:	BLD #N
City	:	DULUTH
State	:	GA
Zip	:	30096-5102
Country	:	US
Telephone Number	:	770-817-9608
Fax Number	:	770-817-9610

Provider Business Practice Location Address
First Line	:	3775 VENTURE DR
Second Line	:	BLD #N
City	:	DULUTH
State	:	GA
Zip	:	30096-5102
Country	:	US
Telephone Number	:	770-817-9608
Fax Number	:	770-817-9610

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. JUNG B KIM
Credential	:	DC
Telephone Number	:	770-817-9608

Provider Enumeration Date	:	10/09/2012
Last Update Date	:	10/09/2012

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