Individual
CHAN KYU PARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.C.
Contact information
Practice address
6630 MCGINNIS FERRY RD, SUITE B, JOHNS CREEK, GA 30097-2164
(678) 473-0552
(678) 473-0656
Mailing address
6630 MCGINNIS FERRY RD STE B, JOHNS CREEK, GA 30097-1563
(678) 473-0552
(678) 473-0656
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
CHIR009022
GA
111NR0400X
Rehabilitation Chiropractor
CHIR009022
GA
111NS0005X
Sports Physician Chiropractor
CHIR009022
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1588908685
GROUP NPI
GA
Enumeration date
10/20/2015
Last updated
01/14/2022
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