Provider Demographics
NPI:1558400457
Name:CHOE, JIMONG (PHD, LAC)
Entity Type:Individual
Prefix:DR
First Name:JIMONG
Middle Name:
Last Name:CHOE
Suffix:
Gender:M
Credentials:PHD, LAC
Other - Prefix:
Other - First Name:JONG
Other - Middle Name:HYUN
Other - Last Name:CHOE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2550 PLEASANT HILL RD
Mailing Address - Street 2:SUITE # 417
Mailing Address - City:DULUTH
Mailing Address - State:GA
Mailing Address - Zip Code:30096-4122
Mailing Address - Country:US
Mailing Address - Phone:770-622-4100
Mailing Address - Fax:770-495-0007
Practice Address - Street 1:2550 PLEASANT HILL RD
Practice Address - Street 2:SUITE # 417
Practice Address - City:DULUTH
Practice Address - State:GA
Practice Address - Zip Code:30096-4122
Practice Address - Country:US
Practice Address - Phone:770-622-4100
Practice Address - Fax:770-495-0007
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA126171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist