Provider Demographics
NPI:1477842961
Name:CHU, QUOC T (DC)
Entity Type:Individual
Prefix:
First Name:QUOC
Middle Name:T
Last Name:CHU
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 1:6681 JONESBORO RD
Mailing Address - Street 2:101
Mailing Address - City:MORROW
Mailing Address - State:GA
Mailing Address - Zip Code:30260-2303
Mailing Address - Country:US
Mailing Address - Phone:678-369-8633
Mailing Address - Fax:
Practice Address - Street 1:6681 JONESBORO RD
Practice Address - Street 2:101
Practice Address - City:MORROW
Practice Address - State:GA
Practice Address - Zip Code:30260-2303
Practice Address - Country:US
Practice Address - Phone:678-369-8633
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-04-05
Last Update Date:2011-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GACHIRO008578111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor