Provider Demographics
NPI:1316603095
Name:CHOI, JUN WON (DC)
Entity type:Individual
Prefix:DR
First Name:JUN
Middle Name:WON
Last Name:CHOI
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4870 WILKIE WAY NW
Mailing Address - Street 2:
Mailing Address - City:ACWORTH
Mailing Address - State:GA
Mailing Address - Zip Code:30102-7929
Mailing Address - Country:US
Mailing Address - Phone:803-537-9522
Mailing Address - Fax:
Practice Address - Street 1:1815 OLD 41 HWY NW STE 370
Practice Address - Street 2:
Practice Address - City:KENNESAW
Practice Address - State:GA
Practice Address - Zip Code:30152-4429
Practice Address - Country:US
Practice Address - Phone:770-575-3103
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-11-16
Last Update Date:2021-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GACHIR010655111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor