Provider Demographics
NPI:1235770744
Name:CHO, PYUNG GANG (LAC)
Entity Type:Individual
Prefix:
First Name:PYUNG GANG
Middle Name:
Last Name:CHO
Suffix:
Gender:F
Credentials:LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5192 LOWER CREEK ST
Mailing Address - Street 2:
Mailing Address - City:PEACHTREE CORNERS
Mailing Address - State:GA
Mailing Address - Zip Code:30092-2395
Mailing Address - Country:US
Mailing Address - Phone:347-331-7237
Mailing Address - Fax:
Practice Address - Street 1:11180 STATE BRIDGE RD STE 205
Practice Address - Street 2:
Practice Address - City:JOHNS CREEK
Practice Address - State:GA
Practice Address - Zip Code:30022-7483
Practice Address - Country:US
Practice Address - Phone:770-703-9939
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-10-05
Last Update Date:2023-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY006560171100000X
GA516171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist