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General NPI Number Information
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NPI Number | 1558809186
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Entity Type | Individual
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Provider Name | JONGHWI KIM DC
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Gender | Male
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Dates
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Enumeration Date | 02/02/2017
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Last Update Date | 12/27/2023
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Provider Practice Location Address
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Address Line | 15280 ROCKAWAY BLVD
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City | JAMAICA
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State | NY
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Zip | 11434-2800
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Country | US
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Telephone | 347-467-6655
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Fax |
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Provider Business Mailing Address
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Address Line | 500 MONMOUTH DR STE 303
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City | MOUNT LAUREL
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State | NJ
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Zip | 08054-5716
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Country | US
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Telephone | 302-434-0101
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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 | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | X012920
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License Number State | NY
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