Provider Demographics
NPI:1689268948
Name:MEDICAL ACUPUNCTURE & NUTRITION, INC.
Entity Type:Organization
Organization Name:MEDICAL ACUPUNCTURE & NUTRITION, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:YU
Authorized Official - Middle Name:
Authorized Official - Last Name:KANG
Authorized Official - Suffix:
Authorized Official - Credentials:LAC
Authorized Official - Phone:404-409-6961
Mailing Address - Street 1:2786 N DECATUR RD STE 220
Mailing Address - Street 2:
Mailing Address - City:DECATUR
Mailing Address - State:GA
Mailing Address - Zip Code:30033-5928
Mailing Address - Country:US
Mailing Address - Phone:404-294-6284
Mailing Address - Fax:
Practice Address - Street 1:2786 N DECATUR RD STE 220
Practice Address - Street 2:
Practice Address - City:DECATUR
Practice Address - State:GA
Practice Address - Zip Code:30033-5928
Practice Address - Country:US
Practice Address - Phone:404-294-6284
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-02-25
Last Update Date:2021-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Multi-Specialty