Provider Demographics
NPI:1437910460
Name:KOKYU HEALING ARTS
Entity Type:Organization
Organization Name:KOKYU HEALING ARTS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:NATALY
Authorized Official - Middle Name:
Authorized Official - Last Name:BAIZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:646-578-1519
Mailing Address - Street 1:619 E COLLEGE AVE STE A
Mailing Address - Street 2:
Mailing Address - City:DECATUR
Mailing Address - State:GA
Mailing Address - Zip Code:30030-5323
Mailing Address - Country:US
Mailing Address - Phone:646-578-1519
Mailing Address - Fax:
Practice Address - Street 1:619 E COLLEGE AVE STE A
Practice Address - Street 2:
Practice Address - City:DECATUR
Practice Address - State:GA
Practice Address - Zip Code:30030-5323
Practice Address - Country:US
Practice Address - Phone:646-578-1519
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-01-17
Last Update Date:2024-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QC1500XAmbulatory Health Care FacilitiesClinic/CenterCommunity Health