Individual
LYDIA K KIM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
450 PINTAIL CT, SUWANEE, GA 30024-6072
(770) 825-3380
(470) 709-2794
Mailing address
450 PINTAIL CT, SUWANEE, GA 30024-6072
(770) 825-3380
(470) 709-2794
Taxonomy
Speciality
Code
Description
License number
State
374U00000X
Home Health Aide
Primary
067-R-1643
GA
Other
Enumeration date
11/02/2018
Last updated
11/02/2018
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