Individual
KYUNGSUN JEONG KIM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHARM D
Contact information
Practice address
5353 S 960 E, #103, SALT LAKE CITY, UT 84117-3569
(801) 288-4013
(801) 288-2485
Mailing address
5353 S 960 E, SALT LAKE CITY, UT 84117-3569
(801) 288-0413
(801) 288-2485
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
58905541701
UT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
58905541701
UTAH DEPARTMENT OF COMMERCE FOR PHARMACY
UT
Enumeration date
12/06/2011
Last updated
12/06/2011
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