Provider Demographics
NPI:1184190365
Name:DONG SHIN ACUPUNCTURE
Entity Type:Organization
Organization Name:DONG SHIN ACUPUNCTURE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:DONG PYO
Authorized Official - Middle Name:
Authorized Official - Last Name:SHIN
Authorized Official - Suffix:
Authorized Official - Credentials:LAC
Authorized Official - Phone:678-858-9466
Mailing Address - Street 1:4500 SATELLITE BLVD STE 2370
Mailing Address - Street 2:
Mailing Address - City:DULUTH
Mailing Address - State:GA
Mailing Address - Zip Code:30096-5067
Mailing Address - Country:US
Mailing Address - Phone:678-858-9644
Mailing Address - Fax:
Practice Address - Street 1:4500 SATELLITE BLVD STE 2370
Practice Address - Street 2:
Practice Address - City:DULUTH
Practice Address - State:GA
Practice Address - Zip Code:30096-5067
Practice Address - Country:US
Practice Address - Phone:678-858-9644
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-10-16
Last Update Date:2018-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Single Specialty