Provider Demographics
NPI:1952529018
Name:JONG KYU KIM, D.C., P.C.
Entity Type:Organization
Organization Name:JONG KYU KIM, D.C., P.C.
Other - Org Name:MING CHIROPRACTIC AND AISAN MEDICINE CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:JONG
Authorized Official - Middle Name:KYU
Authorized Official - Last Name:KIM
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:770-945-9035
Mailing Address - Street 1:1291 OLD PEACHTREE RD NW STE 423
Mailing Address - Street 2:
Mailing Address - City:SUWANEE
Mailing Address - State:GA
Mailing Address - Zip Code:30024-2033
Mailing Address - Country:US
Mailing Address - Phone:770-945-9035
Mailing Address - Fax:770-814-9277
Practice Address - Street 1:1291 OLD PEACHTREE RD NW STE 423
Practice Address - Street 2:
Practice Address - City:SUWANEE
Practice Address - State:GA
Practice Address - Zip Code:30024-2033
Practice Address - Country:US
Practice Address - Phone:770-945-9035
Practice Address - Fax:770-814-9277
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-23
Last Update Date:2013-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GACHIR005241111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty