Provider Demographics
NPI:1164962114
Name:LIM, WOOK (DOM)
Entity Type:Individual
Prefix:
First Name:WOOK
Middle Name:
Last Name:LIM
Suffix:
Gender:M
Credentials:DOM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7032 W HILLSBOROUGH AVE.
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33634
Mailing Address - Country:US
Mailing Address - Phone:813-399-1195
Mailing Address - Fax:813-886-3717
Practice Address - Street 1:7032 W HILLSBOROUGH AVE
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33634-4948
Practice Address - Country:US
Practice Address - Phone:813-399-1195
Practice Address - Fax:813-886-3717
Is Sole Proprietor?:No
Enumeration Date:2017-02-24
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAP3812171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist