BODANIELLE S. PARK L.AC, PHDOM – NPI #1013287150
Acupuncturist

An acupuncturist is a person who performs ancient therapy for alleviation of pain, anesthesia and treatment of some diseases. Acupuncturists use long, fine needles inserted into specific points in order to treat painful conditions or produce anesthesia.

BODANIELLE PARK is an acupuncturist located in LAWRENCEVILLE, GA. NPPES has assigned the NPI number 1013287150 to BODANIELLE PARK on January 06, 2012. It is a Type-1 NPI, indicating this NPI number is associated with an individual. The primary taxonomy selected by this provider is 171100000X from the Health Care Provider Taxonomy code set, which is classified as Acupuncturist.

The NPI profile was previously updated about 5 years ago on Feb 17, 2021. See the complete NPI profile for BODANIELLE PARK below.

NPI Profile for
BODANIELLE S. PARK

NPI Number
1013287150
Enumeration Date

(more than 14 years ago)
Entity Type
Type-1  Individual (Female)
Legal Name
BODANIELLE S. PARK
Credentials
L.AC, PHDOM
Primary location
333 SWANSON DR STE 102
LAWRENCEVILLE, GA 30043-8537
Phone: (678) 878-3069 Fax: (678) 878-4455
1 Other location(s):
3400 McClure Bridge Rd Ste C304
Duluth, GA 30096-8706
Phone: (678) 878-3069
Fax: (678) 878-4455
Mailing address
PO BOX 490186
LAWRENCEVILLE, GA 30049-0004
Phone: (678) 878-3069 Fax: (678) 878-4455
Sole Proprietor
Yes
Updated
Certification Date
Feb 17, 2021

Note: NPPES allows providers to attest to the accuracy of their NPI data. When a provider request any change to the NPI record, they will be able to attest to their changed NPI data, resulting in an updated certification date.

Taxonomy Code(s)

A taxonomy code is a code that describes the health care service provider's type, classification, and the area of specialization. The primary specialty for this provider is indicated as (Primary) below.

Taxonomy Classification / Specialization State License
171100000X
- Acupuncturist (Primary)
GA 355

The taxonomy codes are selected by the provider at the time of NPI registration. Selection of a taxonomy code does not replace any credentialing or validation process that the provider requesting the code should complete.