Provider Demographics
NPI:1598983728
Name:LIU, YONG JIAN (MD)
Entity Type:Individual
Prefix:
First Name:YONG
Middle Name:JIAN
Last Name:LIU
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:6244 CROOKED CREEK RD
Mailing Address - Street 2:STE B
Mailing Address - City:PEACHTREE CORNERS
Mailing Address - State:GA
Mailing Address - Zip Code:30092-6137
Mailing Address - Country:US
Mailing Address - Phone:770-242-0889
Mailing Address - Fax:678-714-6918
Practice Address - Street 1:6244 CROOKED CREEK RD
Practice Address - Street 2:STE B
Practice Address - City:PEACHTREE CORNERS
Practice Address - State:GA
Practice Address - Zip Code:30092-6137
Practice Address - Country:US
Practice Address - Phone:770-242-0889
Practice Address - Fax:678-714-6918
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-23
Last Update Date:2016-02-25
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
GA052409225400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225400000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRehabilitation Practitioner