Provider Demographics
NPI:1699098947
Name:SHIN, JINYOUNG (DC)
Entity type:Individual
Prefix:DR
First Name:JINYOUNG
Middle Name:
Last Name:SHIN
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 1:4720 PEACHTREE INDUSTRIAL BLVD
Mailing Address - Street 2:SUITE-4102
Mailing Address - City:NORCROSS
Mailing Address - State:GA
Mailing Address - Zip Code:30071-5735
Mailing Address - Country:US
Mailing Address - Phone:678-735-7474
Mailing Address - Fax:678-648-9505
Practice Address - Street 1:4720 PEACHTREE INDUSTRIAL BLVD
Practice Address - Street 2:SUITE-4102
Practice Address - City:NORCROSS
Practice Address - State:GA
Practice Address - Zip Code:30071-5735
Practice Address - Country:US
Practice Address - Phone:678-735-7474
Practice Address - Fax:678-648-9505
Is Sole Proprietor?:No
Enumeration Date:2010-03-01
Last Update Date:2010-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GACHIR008581111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor