Provider Demographics
NPI:1750508552
Name:JUNG, IN SEK (PHD, OMD, LAC)
Entity Type:Individual
Prefix:DR
First Name:IN
Middle Name:SEK
Last Name:JUNG
Suffix:
Gender:M
Credentials:PHD, OMD, LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1630 PLEASANT HILL RD
Mailing Address - Street 2:SUITE C-2
Mailing Address - City:DULUTH
Mailing Address - State:GA
Mailing Address - Zip Code:30096-5899
Mailing Address - Country:US
Mailing Address - Phone:678-380-1100
Mailing Address - Fax:678-380-1100
Practice Address - Street 1:1630 PLEASANT HILL RD.
Practice Address - Street 2:STE C-2
Practice Address - City:DULUTH
Practice Address - State:GA
Practice Address - Zip Code:30096-5875
Practice Address - Country:US
Practice Address - Phone:678-380-1100
Practice Address - Fax:678-380-1100
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-20
Last Update Date:2016-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA000050171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist