Organization
ALZNNER 113 WALKING CENTER INC
Active
Other names
Sunnywell
Organization subpart
No
Provider details
NPI number
Authorized official
SUNAE HYUN LEE C.PED (PRESIDENT)
(470) 733-9177
Entity
Organization
Contact information
Practice address
2550 PLEASANT HILL RD STE 106, DULUTH, GA 30096-4153
(470) 733-9177
Mailing address
2550 PLEASANT HILL RD STE 106, DULUTH, GA 30096-4153
(470) 733-9177
Taxonomy
Speciality
Code
Description
License number
State
224L00000X
Pedorthist
—
—
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
332BC3200X
Customized Equipment (DME)
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1215580253
—
GA
Enumeration date
07/18/2019
Last updated
10/24/2019
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