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General NPI Number Information
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NPI Number | 1437180932
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Entity Type | Organization
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Legal Business Name | KIM CHIROPRACTIC & REHAB CENTER
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Dates
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Enumeration Date | 07/05/2006
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Last Update Date | 12/05/2007
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Provider Practice Location Address
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Address Line | 6616 CASTOR AVE
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City | PHILADELPHIA
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State | PA
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Zip | 19149-2120
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Country | US
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Telephone | 215-782-1235
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Fax | 215-782-1239
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Provider Business Mailing Address
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Address Line | 6616 CASTOR AVE
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City | PHILADELPHIA
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State | PA
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Zip | 19149-2120
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Country | US
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Telephone | 215-782-1235
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Fax | 215-782-1239
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. SANG H KIM
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Credential | D.C.
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Telephone | 215-782-1835
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | DC006298L
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License Number State | PA
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