Provider Demographics
NPI:1851717227
Name:CHO, KYUNGHO (DAOM LAC)
Entity Type:Individual
Prefix:DR
First Name:KYUNGHO
Middle Name:
Last Name:CHO
Suffix:
Gender:M
Credentials:DAOM LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:2915 PROFESSIONAL PKWY
Mailing Address - Street 2:STE D
Mailing Address - City:AUGUSTA
Mailing Address - State:GA
Mailing Address - Zip Code:30907-6521
Mailing Address - Country:US
Mailing Address - Phone:706-206-3397
Mailing Address - Fax:706-786-0777
Practice Address - Street 1:2915 PROFESSIONAL PKWY
Practice Address - Street 2:STE D
Practice Address - City:AUGUSTA
Practice Address - State:GA
Practice Address - Zip Code:30907-6521
Practice Address - Country:US
Practice Address - Phone:706-206-3397
Practice Address - Fax:706-786-0777
Is Sole Proprietor?:Yes
Enumeration Date:2014-03-10
Last Update Date:2020-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAC16464171100000X
GA338171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist