Provider Demographics
NPI:1861936759
Name:HWANG, SEUNG YOUNG (LAC)
Entity type:Individual
Prefix:
First Name:SEUNG
Middle Name:YOUNG
Last Name:HWANG
Suffix:
Gender:M
Credentials:LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:339 ATLANTA HWY SE
Mailing Address - Street 2:SUITE 800
Mailing Address - City:WINDER
Mailing Address - State:GA
Mailing Address - Zip Code:30680-7512
Mailing Address - Country:US
Mailing Address - Phone:678-789-4043
Mailing Address - Fax:
Practice Address - Street 1:339 ATLANTA HWY SE
Practice Address - Street 2:SUITE 800
Practice Address - City:WINDER
Practice Address - State:GA
Practice Address - Zip Code:30680-7512
Practice Address - Country:US
Practice Address - Phone:678-789-4043
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-12-12
Last Update Date:2016-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA354171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist