Provider Demographics
NPI:1336434109
Name:KIM, BYUNG YULL (DC)
Entity Type:Individual
Prefix:DR
First Name:BYUNG YULL
Middle Name:
Last Name:KIM
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2856 BUFORD HWY
Mailing Address - Street 2:SUITE 7
Mailing Address - City:DULUTH
Mailing Address - State:GA
Mailing Address - Zip Code:30096-3400
Mailing Address - Country:US
Mailing Address - Phone:678-587-5390
Mailing Address - Fax:678-587-5314
Practice Address - Street 1:2856 BUFORD HWY
Practice Address - Street 2:SUITE 7
Practice Address - City:DULUTH
Practice Address - State:GA
Practice Address - Zip Code:30096-3400
Practice Address - Country:US
Practice Address - Phone:678-587-5390
Practice Address - Fax:678-587-5314
Is Sole Proprietor?:No
Enumeration Date:2011-06-09
Last Update Date:2013-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GACHIR008710111NS0005X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NS0005XChiropractic ProvidersChiropractorSports Physician