Individual
SONG JIN SOPHIE KIM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
13880 BRADDOCK RD, SUITE 301, CENTREVILLE, VA 20121-2459
(703) 222-2773
(703) 222-6093
Mailing address
13880 BRADDOCK RD, SUITE 301, CENTREVILLE, VA 20121-2459
(703) 222-2773
(703) 222-6093
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
0110002960
VA
Other
Enumeration date
03/23/2009
Last updated
02/12/2015
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