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General NPI Number Information
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NPI Number | 1639837529
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Entity Type | Organization
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Legal Business Name | KIBONE LLC
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Dates
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Enumeration Date | 12/08/2021
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Last Update Date | 08/14/2023
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Provider Practice Location Address
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Address Line | 6325 WOODSIDE CT STE 130
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City | COLUMBIA
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State | MD
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Zip | 21046-3214
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Country | US
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Telephone | 443-941-5991
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Fax | 443-300-0678
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Provider Business Mailing Address
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Address Line | 6325 WOODSIDE CT STE 130
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City | COLUMBIA
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State | MD
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Zip | 21046-3214
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Country | US
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Telephone | 443-941-5991
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | ZECHARIAH CHOI
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Credential | ACUPUNCTURIST
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Telephone | 718-216-4115
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number |
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License Number State |
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