Individual
SUSAN HAESOOK KIM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1400 2ND ST, EDMOD, EDMOND, OK 73034
(405) 216-9672
Mailing address
1400 E 2ND ST, EDMOND, OK 73034-5321
(405) 216-9672
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
16673
OK
Other
Enumeration date
09/01/2020
Last updated
09/01/2020
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