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Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.

DR. BODANIELLE S PARK, L.AC, PHDOM

Active Sole Proprietor

DR. BODANIELLE S PARK, L.AC, PHDOM is a Acupuncturist healthcare provider located in LAWRENCEVILLE, Georgia. NPI 1013287150 is currently active in the NPPES registry. Verify at CMS.

Acupuncturist · LAWRENCEVILLE, GA

Registration Details

NPI Number
1013287150
Provider Type
Individual
Gender
Female
NPI Issued
Jan 6, 2012 (14.583553593483 yrs)
Last Updated
Feb 17, 2021
License
355 (GA)
Sole Proprietor
Yes

Practice Information

Address
333 SWANSON DR STE 102
LAWRENCEVILLE, GA, 300438537
Browse GA providers · Browse ZIP 30043
Phone
6788783069
Fax
6788784455
Primary Specialty
Acupuncturist
171100000X

Other Acupuncturist Providers in LAWRENCEVILLE, GA

Name Credential NPI
KIMBERLY SAUL LAC,DIPL.AC. 1619004553
MING MING CHENG 1073769089
LEENA COOK 1588920730
SEONG KEUN PARK L.AC. 1245592211
AZURE DUAN L.AC., DIPL. O.M. 1518348044
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.