Individual
KIM JOHN KAISER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
37 CARDINAL RD, EAST LYME, CT 06333-1045
(860) 691-3033
(860) 691-3006
Mailing address
37 CARDINAL RD, EAST LYME, CT 06333-1045
(860) 691-3033
(860) 691-3006
Taxonomy
Speciality
Code
Description
License number
State
171W00000X
Contractor
06-1357833
CT
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
004101953
—
CT
Enumeration date
11/01/2006
Last updated
04/04/2013
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