Provider Demographics
NPI:1457611220
Name:DULUTH CHIROPRACTIC & ACUPUNCTURE CLINIC DCAC
Entity Type:Organization
Organization Name:DULUTH CHIROPRACTIC & ACUPUNCTURE CLINIC DCAC
Other - Org Name:DCAC LLC
Other - Org Type:Other Name
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:JOOYOUNG
Authorized Official - Middle Name:
Authorized Official - Last Name:KIM
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:770-476-7676
Mailing Address - Street 1:3705 OLD NORCROSS RD
Mailing Address - Street 2:#400
Mailing Address - City:DULUTH
Mailing Address - State:GA
Mailing Address - Zip Code:30096-4335
Mailing Address - Country:US
Mailing Address - Phone:770-476-7676
Mailing Address - Fax:770-476-7679
Practice Address - Street 1:3705 OLD NORCROSS RD
Practice Address - Street 2:#400
Practice Address - City:DULUTH
Practice Address - State:GA
Practice Address - Zip Code:30096-4335
Practice Address - Country:US
Practice Address - Phone:770-476-7676
Practice Address - Fax:770-476-7679
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-05-25
Last Update Date:2012-05-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GACHIR008481111N00000X
GA236171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Multi-Specialty
No171100000XOther Service ProvidersAcupuncturistGroup - Multi-Specialty