Provider Demographics
NPI:1992016042
Name:PARK, SEAN HYUNKI (DC)
Entity Type:Individual
Prefix:DR
First Name:SEAN
Middle Name:HYUNKI
Last Name:PARK
Suffix:
Gender:M
Credentials:DC
Other - Prefix:DR
Other - First Name:HYUN
Other - Middle Name:KI
Other - Last Name:PARK
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DC
Mailing Address - Street 1:3782 PEPPERELL PKWY
Mailing Address - Street 2:
Mailing Address - City:OPELIKA
Mailing Address - State:AL
Mailing Address - Zip Code:36801-6004
Mailing Address - Country:US
Mailing Address - Phone:404-578-2015
Mailing Address - Fax:334-737-5446
Practice Address - Street 1:3782 PEPPERELL PKWY
Practice Address - Street 2:
Practice Address - City:OPELIKA
Practice Address - State:AL
Practice Address - Zip Code:36801-6004
Practice Address - Country:US
Practice Address - Phone:334-737-5445
Practice Address - Fax:334-737-5446
Is Sole Proprietor?:Yes
Enumeration Date:2010-06-23
Last Update Date:2014-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA006771111N00000X
AL2424111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor