Provider Demographics
NPI:1194154898
Name:GOOD NEWS WELLNESS AND BEAUTY
Entity type:Organization
Organization Name:GOOD NEWS WELLNESS AND BEAUTY
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:SEAN
Authorized Official - Middle Name:
Authorized Official - Last Name:PARK
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:404-578-2015
Mailing Address - Street 1:2550 PLEASANT HILL RD
Mailing Address - Street 2:STE 124
Mailing Address - City:DULUTH
Mailing Address - State:GA
Mailing Address - Zip Code:30096-4122
Mailing Address - Country:US
Mailing Address - Phone:404-578-2015
Mailing Address - Fax:
Practice Address - Street 1:2550 PLEASANT HILL RD
Practice Address - Street 2:STE 124
Practice Address - City:DULUTH
Practice Address - State:GA
Practice Address - Zip Code:30096-4122
Practice Address - Country:US
Practice Address - Phone:404-578-2015
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-11-04
Last Update Date:2013-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GACHIR 006771111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty