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Individual

KIKWANG NAM

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
D.C.

Contact information

Practice address
10900 MEDLOCK BRIDGE RD STE 202, JOHNS CREEK, GA 30097-1505
(770) 418-2340
(770) 418-9011
Mailing address
10900 MEDLOCK BRIDGE RD STE 202, JOHNS CREEK, GA 30097-1505
(770) 418-2340
(770) 418-9011

Taxonomy

Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
CHIR008082
GA
111NI0013X
Independent Medical Examiner Chiropractor
CHIR008082
GA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1013249978
NPI
GA
Enumeration date
05/21/2015
Last updated
05/21/2015
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