Individual
MICHELLE KIM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OD
Contact information
Practice address
180 W GIRARD AVE STE 5, PHILADELPHIA, PA 19123-1660
(215) 554-6222
(215) 554-6200
Mailing address
5597 TULIP ST STE B8, PHILADELPHIA, PA 19124-1562
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
OEG004137
PA
152W00000X
Optometrist
Primary
TUV009823-01
NY
Other
Enumeration date
07/05/2023
Last updated
07/01/2024
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