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General NPI Number Information
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NPI Number | 1861385148
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Entity Type | Organization
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Legal Business Name | KJ KIM CHIROPRACTIC PC
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Dates
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Enumeration Date | 06/03/2025
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Last Update Date | 06/03/2025
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Provider Practice Location Address
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Address Line | 12 E 44TH ST FL 5
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City | NEW YORK
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State | NY
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Zip | 10017-3624
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Country | US
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Telephone | 929-777-0754
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Fax |
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Provider Business Mailing Address
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Address Line | 4312 54TH ST
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City | WOODSIDE
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State | NY
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Zip | 11377-4639
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Country | US
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Telephone | 929-777-0754
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Fax |
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Authorized Official
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Title or Position | PRESIDENT/ CHIROPRACTIC
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Name | DR. KYUNG JOON KIM
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Credential | DC (CHIROPRACTIC)
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Telephone | 929-777-0754
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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 |
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License Number State |
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