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General NPI Number Information
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NPI Number | 1316288327
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Entity Type | Organization
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Legal Business Name | BRIGHTACUPUNCTURE
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Dates
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Enumeration Date | 03/15/2013
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Last Update Date | 03/15/2013
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Provider Practice Location Address
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Address Line | 296 N MAIN ST
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City | SPRING VALLEY
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State | NY
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Zip | 10977-3736
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Country | US
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Telephone | 917-582-6187
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Fax |
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Provider Business Mailing Address
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Address Line | 296 N MAIN ST
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City | SPRING VALLEY
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State | NY
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Zip | 10977-3736
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Country | US
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Telephone | 917-582-6187
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Fax |
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Authorized Official
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Title or Position | DOCTOR
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Name | DR. MISUK KIM
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Credential | L.AC
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Telephone | 917-582-6187
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 171100000X
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Taxonomy Name | Acupuncturist
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License Number | 0033641
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License Number State | NJ
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