MEDICARE: HYE SOON YOO

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	225700000X	Massage Therapist	MT012281	GA

General Provider Information

NPI Number	:	1730045568
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	HYE SOON YOO

Provider Business Mailing Address
First Line	:	2865 SENATOR CT
Second Line	:
City	:	BUFORD
State	:	GA
Zip	:	30519-8034
Country	:	US
Telephone Number	:	770-337-4456
Fax Number	:

Provider Business Practice Location Address
First Line	:	2790 LAWRENCEVILLE SUWANEE RD STE 240
Second Line	:
City	:	SUWANEE
State	:	GA
Zip	:	30024-2671
Country	:	US
Telephone Number	:	770-337-4456
Fax Number	:

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

Provider Enumeration Date	:	12/23/2025
Last Update Date	:	12/23/2025

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Directions to “ HYE SOON YOO ” Practice Location

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