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NPI Code Detail

MEDICARE: HYEON JOO KIM

MEDICARE:   HYEON JOO KIM
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
1171100000XAcupuncturist50503621201UT

General Provider Information

NPI Number : 1710044912
Entity Type Code : Individual
Provider Name (Legal Business Name) : HYEON JOO KIM
Provider Business Mailing Address
First Line : 153 E 4370 S
Second Line : SUITE 16
City : MURRAY
State : UT
Zip : 84107-2624
Country : US
Telephone Number : 801-287-9559
Fax Number :
Provider Business Practice Location Address
First Line : 153 EAST 4370 SOUTH
Second Line : #16
City : MURRAY
State : UT
Zip : 84107-2608
Country : US
Telephone Number : 801-287-9559
Fax Number : 801-287-9559
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/03/2007
Last Update Date : 10/22/2014

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Directions to “ HYEON JOO KIM ” Practice Location

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