Provider Demographics
NPI:1831429489
Name:PARK, MYOUNG S (DC)
Entity type:Individual
Prefix:DR
First Name:MYOUNG
Middle Name:S
Last Name:PARK
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
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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
Is Sole Proprietor?:Yes
Enumeration Date:2010-01-04
Last Update Date:2023-12-29
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
GACHIR008420111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor