Provider Demographics
NPI:1063823581
Name:DANA HEALTH AND WELLNESS CENTER INC
Entity type:Organization
Organization Name:DANA HEALTH AND WELLNESS CENTER INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:DC / PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:WOO
Authorized Official - Middle Name:JIN
Authorized Official - Last Name:KIM
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:770-623-9229
Mailing Address - Street 1:2472 PLEASANT HILL RD
Mailing Address - Street 2:203A
Mailing Address - City:DULUTH
Mailing Address - State:GA
Mailing Address - Zip Code:30096-1746
Mailing Address - Country:US
Mailing Address - Phone:770-623-9229
Mailing Address - Fax:866-868-8705
Practice Address - Street 1:2472 PLEASANT HILL RD
Practice Address - Street 2:203A
Practice Address - City:DULUTH
Practice Address - State:GA
Practice Address - Zip Code:30096-1746
Practice Address - Country:US
Practice Address - Phone:770-623-9229
Practice Address - Fax:866-868-8705
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-05-19
Last Update Date:2014-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
111N00000X
GA27746208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Multi-Specialty
No111N00000XChiropractic ProvidersChiropractorGroup - Multi-Specialty