Park, Chan Kyu

Park, Chan Kyu is an individual health care provider with primary practice located at 6630 Mcginnis Ferry Rd Suite B, Johns Creek GA 30097-2164. He recently has 3 registered licenses in different health care specialties including Chiropractic Providers / Rehabilitation, Chiropractic Providers / Sports Physician, Chiropractic Providers / Chiropractor. Chiropractic Providers / Chiropractor is his primary health care specialty. Park, Chan Kyu can be contacted via phone (678) 473-0552.

Contact Information

Primary practice address
6630 Mcginnis Ferry Rd Suite B Johns Creek GA 30097-2164
Phone: (678) 473-0552
Fax: (678) 473-0656
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Chiropractic Providers / Rehabilitation 111NR0400X CHIR009022 Georgia
Chiropractic Providers / Sports Physician 111NS0005X CHIR009022 Georgia
Chiropractic Providers / Chiropractor 111N00000X CHIR009022 Georgia

Profile Details

NPI number 1639541485
LBN Legal business name Park, Chan Kyu
Credentials Doctor of Chiropractic (DC)
Entity Individual
Sole proprietor 1 No
Enumeration date Oct 20th, 2015
Last updated Jan 14th, 2022 - about 2 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1639541485 NPPES
Georgia Other 1588908685 GROUP NPI

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