Provider Demographics
NPI:1508219304
Name:PARKS ACUPUNCTURE & HERBS LLC
Entity Type:Organization
Organization Name:PARKS ACUPUNCTURE & HERBS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ACUPUNCTURIST
Authorized Official - Prefix:MR
Authorized Official - First Name:HOJUN
Authorized Official - Middle Name:
Authorized Official - Last Name:PARK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:404-935-2200
Mailing Address - Street 1:3631 PEACHTREE INDUSTRIAL BLVD STE 106
Mailing Address - Street 2:
Mailing Address - City:DULUTH
Mailing Address - State:GA
Mailing Address - Zip Code:30096-4851
Mailing Address - Country:US
Mailing Address - Phone:404-935-2200
Mailing Address - Fax:
Practice Address - Street 1:3631 PEACHTREE INDUSTRIAL BLVD STE 106
Practice Address - Street 2:
Practice Address - City:DULUTH
Practice Address - State:GA
Practice Address - Zip Code:30096-4851
Practice Address - Country:US
Practice Address - Phone:404-935-2200
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-07-15
Last Update Date:2016-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA327171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA327OtherACUPUNCTURIST