Provider Demographics
NPI:1649315706
Name:KIM, JOOYOUNG (DC)
Entity type:Individual
Prefix:
First Name:JOOYOUNG
Middle Name:
Last Name:KIM
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3300 HAMILTON MILL RD STE 108
Mailing Address - Street 2:
Mailing Address - City:BUFORD
Mailing Address - State:GA
Mailing Address - Zip Code:30519-4083
Mailing Address - Country:US
Mailing Address - Phone:770-476-7676
Mailing Address - Fax:770-710-0123
Practice Address - Street 1:3300 HAMILTON MILL RD STE 108
Practice Address - Street 2:
Practice Address - City:BUFORD
Practice Address - State:GA
Practice Address - Zip Code:30519
Practice Address - Country:US
Practice Address - Phone:770-476-7676
Practice Address - Fax:770-710-0123
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-20
Last Update Date:2018-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC 29950111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor