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General NPI Number Information
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NPI Number | 1013662469
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Entity Type | Individual
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Provider Name | DANIEL KIM
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Gender | Male
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Dates
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Enumeration Date | 02/15/2022
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Last Update Date | 02/15/2022
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Provider Practice Location Address
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Address Line | 43330 JUNCTION PLZ STE 122
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City | ASHBURN
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State | VA
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Zip | 20147-3407
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Country | US
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Telephone | 703-972-1040
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Fax |
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Provider Business Mailing Address
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Address Line | 25316 RIPLEYS FIELD DR
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City | CHANTILLY
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State | VA
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Zip | 20152-4443
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Country | US
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Telephone | 774-258-1959
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number |
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License Number State |
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