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Active NPI 1013287150 Individual Practitioner Female Practitioner

Bodanielle S Park , LAC, PHDOM

Acupuncturist • Lawrenceville, GA

Professional Overview & Biography Verified Profile Summary

Bodanielle Park, LAC, PHDOM is a registered healthcare professional specializing in Acupuncturist in Lawrenceville, GA. Practice services are available at 333 SWANSON DR STE 102 under active NPI credentials.

Practice Location & Contact Primary Location

Practice Address

333 Swanson Dr Ste 102

Lawrenceville, GA 300438537

Telephone 6788783069
Fax 6788784455
Associated Practice Facility / Clinic

Specialty Benchmarks & Practice Insights

Comparative analytics for Acupuncturist in Lawrenceville, GA

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 10.5 Yrs
State Avg: 3.0 Yrs
Regional Practice Density
7 Specialists

Practicing in Lawrenceville, GA (280 Statewide)

Telehealth Adoption Rate
0.0% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
67.4% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Medical Specialties & State Licenses

CMS Verified: 2021-02-17
Acupuncturist Primary Specialty

NUCC Taxonomy Code: 171100000X

State License GA 355

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.

Secondary Practice Locations

3400 Mcclure Bridge Rd Ste C304

Duluth, GA 300968706

Phone: 6788783069

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

4 Associated Practitioners
Dana Gunter

Massage Therapist

NPI 1013566058
Joshua Lane , LAC

Acupuncturist

NPI 1306404603

Licensed Acupuncturist

NPI 1487174223

MASSAGETHERAPIST

Karen Fulmer , LMT

Massage Therapist

NPI 1679167365

Licensed Massage Therapist

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

13 Historical Events
📍
Updated Practice Location February 17, 2021

Registered at 333 SWANSON DR STE 102, LAWRENCEVILLE, GA 300438537 (Tel: 6788783069)

📍
Updated Business Mailing Address February 17, 2021

Registered at PO BOX 490186, LAWRENCEVILLE, GA 300490004 (Tel: 6788783069)

NPI Profile Active November 01, 2017

NPI status registered as active in NPPES database

📍
Updated Practice Location November 01, 2017

Registered at 3400 MCCLURE BRIDGE RD STE C304, DULUTH, GA 300968706 (Tel: 6788783069)

📍
Updated Business Mailing Address November 01, 2017

Registered at 3090 ABBOTTS POINTE DR, DULUTH, GA 300972170 (Tel: 6788783069)

👤
Provider Name / Credentials Updated November 01, 2017

Recorded as BODANIELLE PARK, L.AC, PHDOM

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) November 01, 2017

Acupuncturist (License #355 in GA)

NPI Profile Active November 03, 2014

NPI status registered as active in NPPES database

📍
Updated Practice Location November 03, 2014

Registered at 3090 ABBOTTS POINTE DR, DULUTH, GA 300972170 (Tel: 4232992033)

📍
Updated Business Mailing Address November 03, 2014

Registered at 3090 ABBOTTS POINTE DR, DULUTH, GA 300972170 (Tel: 4232992033)

👤
Provider Name / Credentials Updated November 03, 2014

Recorded as BODANIELLE PARK, L.AC, PHDOM

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) November 03, 2014

Acupuncturist (License #355 in GA)

🟢
Initial NPI Registration & Enumeration January 06, 2012

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

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NPI Administrative Meta

NPI Number: 1013287150
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: January 06, 2012
Last Update: February 17, 2021
Sole Proprietor: Yes

Mailing Address

Po Box 490186

Lawrenceville, GA 300490004

Phone: 6788783069

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).
⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.