Provider Demographics
NPI:1841626512
Name:HONG, SEUNGMO (DC)
Entity type:Individual
Prefix:MR
First Name:SEUNGMO
Middle Name:
Last Name:HONG
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 1:80 HORIZON DR
Mailing Address - Street 2:SUITE 302
Mailing Address - City:SUWANEE
Mailing Address - State:GA
Mailing Address - Zip Code:30024
Mailing Address - Country:US
Mailing Address - Phone:678-765-6230
Mailing Address - Fax:678-765-6630
Practice Address - Street 1:80 HORIZON DR
Practice Address - Street 2:SUITE 302
Practice Address - City:SUWANEE
Practice Address - State:GA
Practice Address - Zip Code:30024
Practice Address - Country:US
Practice Address - Phone:678-765-6230
Practice Address - Fax:678-765-6630
Is Sole Proprietor?:Yes
Enumeration Date:2013-09-25
Last Update Date:2019-11-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GACHIR009111111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor