Individual
DR. TONY KYUNGSOO KIM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.C.
Contact information
Practice address
2100 MARKET ST, SUITE 100, CHARLESTOWN, IN 47111-9535
(502) 244-9859
(770) 573-9513
Mailing address
24318 HEMLOCK AVE, E5, MORENO VALLEY, CA 92557-7222
(951) 485-1918
(951) 346-5600
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
DC27102
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
08002884A
INDIANA LICENSE
IN
Enumeration date
05/23/2005
Last updated
03/28/2016
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