Provider Demographics
NPI:1124386594
Name:HANSARANG CLINIC LLC
Entity Type:Organization
Organization Name:HANSARANG CLINIC LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:YOUNG
Authorized Official - Middle Name:SOO
Authorized Official - Last Name:JEAN
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:770-232-7222
Mailing Address - Street 1:2174 PLEASANT HILL RD
Mailing Address - Street 2:SUITE 106
Mailing Address - City:DULUTH
Mailing Address - State:GA
Mailing Address - Zip Code:30096-4606
Mailing Address - Country:US
Mailing Address - Phone:770-232-7222
Mailing Address - Fax:
Practice Address - Street 1:2174 PLEASANT HILL RD
Practice Address - Street 2:SUITE 106
Practice Address - City:DULUTH
Practice Address - State:GA
Practice Address - Zip Code:30096-4606
Practice Address - Country:US
Practice Address - Phone:770-232-7222
Practice Address - Fax:770-232-7223
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-04-24
Last Update Date:2012-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GACHIR008045111NI0013X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111NI0013XChiropractic ProvidersChiropractorIndependent Medical ExaminerGroup - Single Specialty