Provider Demographics
NPI:1093030009
Name:JANG, EUNA (OMD)
Entity type:Individual
Prefix:DR
First Name:EUNA
Middle Name:
Last Name:JANG
Suffix:
Gender:F
Credentials:OMD
Other - Prefix:
Other - First Name:EUNA
Other - Middle Name:
Other - Last Name:KIM
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2800 PEACHTREE INDUSTRIAL BLVD
Mailing Address - Street 2:SUITE A
Mailing Address - City:DULUTH
Mailing Address - State:GA
Mailing Address - Zip Code:30097-7912
Mailing Address - Country:US
Mailing Address - Phone:404-519-7313
Mailing Address - Fax:
Practice Address - Street 1:2800 PEACHTREE INDUSTRIAL BLVD
Practice Address - Street 2:SUITE A
Practice Address - City:DULUTH
Practice Address - State:GA
Practice Address - Zip Code:30097-7912
Practice Address - Country:US
Practice Address - Phone:404-519-7313
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-04-01
Last Update Date:2010-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA241171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist