Individual
GRACE KIM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
5225 WILSON LN, MECHANICSBURG, PA 17055-6663
(717) 766-0279
Mailing address
631 GATES LN, ENOLA, PA 17025-1610
(717) 982-7665
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
OC015831
PA
Other
Enumeration date
10/08/2019
Last updated
12/26/2023
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