Provider Demographics
NPI:1043489149
Name:KIM CHIROPRACTIC & REHAB CENTER- CHERRY HILL INC
Entity Type:Organization
Organization Name:KIM CHIROPRACTIC & REHAB CENTER- CHERRY HILL INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DOCTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:JHAN
Authorized Official - Middle Name:D
Authorized Official - Last Name:KIM
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:267-342-0178
Mailing Address - Street 1:1916 OLD CUTHBERT RD
Mailing Address - Street 2:SUITE A1
Mailing Address - City:CHERRY HILL
Mailing Address - State:NJ
Mailing Address - Zip Code:08034-1457
Mailing Address - Country:US
Mailing Address - Phone:856-354-0403
Mailing Address - Fax:856-354-6200
Practice Address - Street 1:1916 OLD CUTHBERT RD
Practice Address - Street 2:SUITE A1
Practice Address - City:CHERRY HILL
Practice Address - State:NJ
Practice Address - Zip Code:08034-1457
Practice Address - Country:US
Practice Address - Phone:856-354-0403
Practice Address - Fax:856-354-6200
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-02-22
Last Update Date:2011-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty