Individual
VESTA KIM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
OPTICIAN
Contact information
Practice address
14-22 PROSPECT STREET, EAST BRUNSWICK, NJ 08816-5808
(732) 257-3755
(732) 257-5573
Mailing address
14-22 PROSPECT STREET, EAST BRUNSWICK, NJ 08816-5808
(732) 257-3755
(732) 257-5573
Taxonomy
Speciality
Code
Description
License number
State
156FX1800X
Optician
Primary
31TD00367900
NJ
Other
Enumeration date
06/24/2011
Last updated
07/07/2011
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