Healthcare Provider Details

I. General information

NPI: 1922482942
Provider Name (Legal Business Name): KIMS ACUPUNCTURE & HERBAL MEDS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/20/2015
Last Update Date: 07/20/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

153 E 4370 S STE 16
MURRAY UT
84107-2608
US

IV. Provider business mailing address

153 E 4370 S STE 16
MURRAY UT
84107-2608
US

V. Phone/Fax

Practice location:
  • Phone: 801-287-9559
  • Fax:
Mailing address:
  • Phone: 801-287-9559
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: HYEON JOO KIM
Title or Position: OWNER/LAC/OMD
Credential:
Phone: 801-287-9559