Provider Demographics
NPI:1063720589
Name:KO, JIN M (DC)
Entity type:Individual
Prefix:DR
First Name:JIN
Middle Name:M
Last Name:KO
Suffix:
Gender:M
Credentials:DC
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Mailing Address - Street 1:1295 OLD PEACHTREE RD NW
Mailing Address - Street 2:STE 270
Mailing Address - City:SUWANEE
Mailing Address - State:GA
Mailing Address - Zip Code:30024-2726
Mailing Address - Country:US
Mailing Address - Phone:404-932-9770
Mailing Address - Fax:678-261-1680
Practice Address - Street 1:1295 OLD PEACHTREE RD NW
Practice Address - Street 2:STE 270
Practice Address - City:SUWANEE
Practice Address - State:GA
Practice Address - Zip Code:30024-2726
Practice Address - Country:US
Practice Address - Phone:404-932-9770
Practice Address - Fax:678-261-1680
Is Sole Proprietor?:No
Enumeration Date:2010-09-17
Last Update Date:2010-09-17
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
GACHIR007284111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor