Individual
MR. JUSTIN INSUN KIM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PT, DPT
Contact information
Practice address
388 YPAO RD, TAMUNING, GU 96913-3701
(671) 646-8881
(671) 648-2548
Mailing address
13355 W CHOCTAW TRL, HOMER GLEN, IL 60491-8664
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
070.019618
IL
225100000X
Physical Therapist
Primary
PT-137
GU
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1427393628
—
GU
Enumeration date
11/29/2012
Last updated
03/26/2019
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