Provider Demographics
NPI:1003081027
Name:KIM, CHINSUK (LICENSED ACUPUNCTRIS)
Entity Type:Individual
Prefix:MRS
First Name:CHINSUK
Middle Name:
Last Name:KIM
Suffix:
Gender:F
Credentials:LICENSED ACUPUNCTRIS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 2162
Mailing Address - Street 2:
Mailing Address - City:SATERN
Mailing Address - State:NH
Mailing Address - Zip Code:03079
Mailing Address - Country:US
Mailing Address - Phone:603-893-8213
Mailing Address - Fax:
Practice Address - Street 1:22 HAWK DRIVE
Practice Address - Street 2:
Practice Address - City:SATERN
Practice Address - State:NH
Practice Address - Zip Code:03079
Practice Address - Country:US
Practice Address - Phone:603-893-8213
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-04-30
Last Update Date:2008-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA68171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist