Provider Demographics
NPI:1336326305
Name:PAK, HYUNG (DC)
Entity Type:Individual
Prefix:DR
First Name:HYUNG
Middle Name:
Last Name:PAK
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2244 MOUNT ZION RD
Mailing Address - Street 2:
Mailing Address - City:JONESBORO
Mailing Address - State:GA
Mailing Address - Zip Code:30236-2528
Mailing Address - Country:US
Mailing Address - Phone:678-610-7587
Mailing Address - Fax:678-610-4047
Practice Address - Street 1:2244 MOUNT ZION RD
Practice Address - Street 2:
Practice Address - City:JONESBORO
Practice Address - State:GA
Practice Address - Zip Code:30236-2528
Practice Address - Country:US
Practice Address - Phone:678-610-7587
Practice Address - Fax:678-610-4047
Is Sole Proprietor?:No
Enumeration Date:2008-01-22
Last Update Date:2018-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GACHIR007891111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor