Provider Demographics
NPI:1346641008
Name:YI, PATRICK BK (DC)
Entity Type:Individual
Prefix:DR
First Name:PATRICK
Middle Name:BK
Last Name:YI
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 1:80 HORIZON DR STE 302
Mailing Address - Street 2:
Mailing Address - City:SUWANEE
Mailing Address - State:GA
Mailing Address - Zip Code:30024-7740
Mailing Address - Country:US
Mailing Address - Phone:678-765-6230
Mailing Address - Fax:678-765-6630
Practice Address - Street 1:80 HORIZON DR STE 302
Practice Address - Street 2:
Practice Address - City:SUWANEE
Practice Address - State:GA
Practice Address - Zip Code:30024
Practice Address - Country:US
Practice Address - Phone:678-765-6230
Practice Address - Fax:678-765-6630
Is Sole Proprietor?:Yes
Enumeration Date:2014-09-11
Last Update Date:2023-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GACHIR009384111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
GACHIR009384OtherCHIROPRACTIC LICENSE
GACHIR009384OtherCHIROPRACTIC