MEDICARE: DR. SEUNG GOO CHUNG D.C

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	CHIR007571	GA

General Provider Information

NPI Number	:	1457404899
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. SEUNG GOO CHUNG D.C

Provider Business Mailing Address
First Line	:	3499 DULUTH PARK LN STE 210
Second Line	:
City	:	DULUTH
State	:	GA
Zip	:	30096-3259
Country	:	US
Telephone Number	:	770-622-8383
Fax Number	:	770-622-8384

Provider Business Practice Location Address
First Line	:	3499 DULUTH PARK LN STE 210
Second Line	:
City	:	DULUTH
State	:	GA
Zip	:	30096-3259
Country	:	US
Telephone Number	:	770-622-8383
Fax Number	:	770-622-8384

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/19/2007
Last Update Date	:	07/08/2007

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