MEDICARE: SEYOUNG KIM D.C.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	111N00000X	Chiropractor	2658	OK

General Provider Information

NPI Number	:	1326163247
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SEYOUNG KIM D.C.

Provider Business Mailing Address
First Line	:	3435 NW 50TH ST
Second Line	:
City	:	OKLAHOMA CITY
State	:	OK
Zip	:	73112-5602
Country	:	US
Telephone Number	:	405-942-4040
Fax Number	:

Provider Business Practice Location Address
First Line	:	3435 NW 50TH ST
Second Line	:
City	:	OKLAHOMA CITY
State	:	OK
Zip	:	73112-5602
Country	:	US
Telephone Number	:	405-942-4040
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/20/2007
Last Update Date	:	12/23/2015

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Directions to “ SEYOUNG KIM D.C.” Practice Location

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