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General NPI Number Information
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NPI Number | 1740344530
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Entity Type | Individual
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Provider Name | BRUCE KIM L.AC
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Gender | Male
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Dates
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Enumeration Date | 12/19/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 2840 KELLER SPRINGS RD SUITE #102
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City | CARROLLTON
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State | TX
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Zip | 75006-4829
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Country | US
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Telephone | 972-418-1776
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Fax | 972-418-1779
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Provider Business Mailing Address
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Address Line | 2911 PANORAMA DR
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City | CARROLLTON
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State | TX
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Zip | 75007-4303
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Country | US
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Telephone | 972-245-1672
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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 | 171100000X
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Taxonomy Name | Acupuncturist
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License Number | AC00662
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License Number State | TX
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