Provider Demographics
NPI:1013713486
Name:SEO, JIN HO (DC)
Entity type:Individual
Prefix:DR
First Name:JIN
Middle Name:HO
Last Name:SEO
Suffix:
Gender:
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1290 OLD PEACHTREE RD APT 5127
Mailing Address - Street 2:
Mailing Address - City:DULUTH
Mailing Address - State:GA
Mailing Address - Zip Code:30097-5336
Mailing Address - Country:US
Mailing Address - Phone:678-544-3221
Mailing Address - Fax:
Practice Address - Street 1:2800 LAWRENCEVILLE SUWANEE RD
Practice Address - Street 2:
Practice Address - City:SUWANEE
Practice Address - State:GA
Practice Address - Zip Code:30024-2531
Practice Address - Country:US
Practice Address - Phone:678-926-3868
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-02-24
Last Update Date:2025-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GACHIR011363111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor