Healthcare Provider Details

I. General information

NPI: 1245201888
Provider Name (Legal Business Name): JHAN KIM D.C.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/31/2006
Last Update Date: 06/09/2023
Certification Date: 06/01/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7301 MOUNTAIN AVENUE
ELKINS PARK PA
19027
US

IV. Provider business mailing address

921 W CHELTENHAM AVE
ELKINS PARK PA
19027-3208
US

V. Phone/Fax

Practice location:
  • Phone: 215-782-1237
  • Fax: 215-782-1239
Mailing address:
  • Phone: 215-782-1235
  • Fax: 215-782-1239

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171100000X
TaxonomyAcupuncturist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: