Individual
JUNGHA BACK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
1726 W 3RD ST, MONTGOMERY, AL 36106-1506
(334) 593-3932
(334) 593-7715
Mailing address
1726 W 3RD ST, MONTGOMERY, AL 36106-1506
(334) 593-3932
Taxonomy
Speciality
Code
Description
License number
State
156FX1800X
Optician
Primary
232077
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1225700230
—
AL
05
—
276390
—
AL
Enumeration date
11/03/2022
Last updated
11/03/2022
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