Individual
JINAH KIM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
545 COLUMBIA LN, PROVO, UT 84604-2450
(385) 477-4942
Mailing address
545 COLUMBIA LN, PROVO, UT 84604-2450
(385) 477-4942
(385) 477-4945
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
10696568
UT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3008051
—
UT
Enumeration date
03/09/2020
Last updated
01/19/2021
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