Individual
MARK JIN KIM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PHARMD
Contact information
Practice address
1801 SOUTH ST., LAFAYETTE, IN 47905
(765) 448-1366
Mailing address
316 EAST PINE AVE, WEST LAFAYETTE, IN 47906
(765) 404-1708
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
26023806A
IN
Other
Enumeration date
10/13/2011
Last updated
10/13/2011
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