Provider Demographics
NPI:1245359058
Name:JK HEALTH CARE GROUP INC,(CONSTITUION MEDICINE & CHIROPRACTIC CENTER)
Entity type:Organization
Organization Name:JK HEALTH CARE GROUP INC,(CONSTITUION MEDICINE & CHIROPRACTIC CENTER)
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:JUNG
Authorized Official - Middle Name:B
Authorized Official - Last Name:KIM
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:770-814-7400
Mailing Address - Street 1:2550 PLEASANT HILL RD STE 124
Mailing Address - Street 2:
Mailing Address - City:DULUTH
Mailing Address - State:GA
Mailing Address - Zip Code:30096-9278
Mailing Address - Country:US
Mailing Address - Phone:770-814-7400
Mailing Address - Fax:770-814-7442
Practice Address - Street 1:2550 PLEASANT HILL RD STE 124
Practice Address - Street 2:
Practice Address - City:DULUTH
Practice Address - State:GA
Practice Address - Zip Code:30096-9278
Practice Address - Country:US
Practice Address - Phone:770-814-7400
Practice Address - Fax:770-814-7442
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-29
Last Update Date:2010-12-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA7922111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty