MEDICARE: HOLY HILL ACUPUNCTURE 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	171100000X	Acupuncturist

General Provider Information

NPI Number	:	1912875048
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HOLY HILL ACUPUNCTURE LLC

Provider Business Mailing Address
First Line	:	3525 MALL BLVD STE 7D
Second Line	:
City	:	DULUTH
State	:	GA
Zip	:	30096-4727
Country	:	US
Telephone Number	:	470-417-4888
Fax Number	:

Provider Business Practice Location Address
First Line	:	3525 MALL BLVD STE 7D
Second Line	:
City	:	DULUTH
State	:	GA
Zip	:	30096-4727
Country	:	US
Telephone Number	:	470-417-4888
Fax Number	:

Authorized Official
Title or Position	:	ACUPUNCTURIST/OWNER
Name	:	JOSHUAH SUNGGON KIM
Credential	:	L.AC.
Telephone Number	:	470-417-4888

Provider Enumeration Date	:	10/29/2025
Last Update Date	:	10/29/2025

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