Individual
MICHELE KIM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
C.PED
Contact information
Practice address
1402 BERGEN BLVD, FORT LEE, NJ 07024-2116
(201) 328-2776
Mailing address
1402 BERGEN BLVD, FORT LEE, NJ 07024-2116
(201) 328-2776
Taxonomy
Speciality
Code
Description
License number
State
224L00000X
Pedorthist
Primary
CPED4638
NJ
Other
Enumeration date
04/23/2024
Last updated
04/23/2024
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