Individual
JI KIM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
L.AC
Contact information
Practice address
196 MAIN ST, NANUET, NY 10954-3324
(845) 501-7878
Mailing address
196 MAIN ST, NANUET, NY 10954-3324
(845) 501-7878
Taxonomy
Speciality
Code
Description
License number
State
171100000X
Acupuncturist
Primary
006208
NY
Other
Enumeration date
08/15/2019
Last updated
03/04/2020
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