Provider Demographics
NPI:1770213936
Name:JIM, HEI TUNG (DPT)
Entity Type:Individual
Prefix:
First Name:HEI TUNG
Middle Name:
Last Name:JIM
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:KAREN HEI TUNG
Other - Middle Name:
Other - Last Name:JIM
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:DPT
Mailing Address - Street 1:900 CIRCLE 75 PKWY SE STE 1700
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30339-3087
Mailing Address - Country:US
Mailing Address - Phone:678-996-7230
Mailing Address - Fax:
Practice Address - Street 1:3929 PEACHTREE RD NE STE 220
Practice Address - Street 2:
Practice Address - City:BROOKHAVEN
Practice Address - State:GA
Practice Address - Zip Code:30319-3374
Practice Address - Country:US
Practice Address - Phone:678-684-2220
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-06-12
Last Update Date:2022-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAPT015971225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
GAPT015971OtherLICENSE