Provider Demographics
NPI:1306228820
Name:MIND BODY HEALTH, LLC
Entity Type:Organization
Organization Name:MIND BODY HEALTH, LLC
Other - Org Name:DON KIM ACUPUNCTURE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ACUPUNCTURIST
Authorized Official - Prefix:
Authorized Official - First Name:DONG JIN
Authorized Official - Middle Name:
Authorized Official - Last Name:KIM
Authorized Official - Suffix:
Authorized Official - Credentials:DIPL OM, LAC
Authorized Official - Phone:201-857-0888
Mailing Address - Street 1:18 SYCAMORE AVE
Mailing Address - Street 2:SUITE 2
Mailing Address - City:HO HO KUS
Mailing Address - State:NJ
Mailing Address - Zip Code:07423-1582
Mailing Address - Country:US
Mailing Address - Phone:201-857-0888
Mailing Address - Fax:
Practice Address - Street 1:18 SYCAMORE AVE
Practice Address - Street 2:SUITE 2
Practice Address - City:HO HO KUS
Practice Address - State:NJ
Practice Address - Zip Code:07423-1582
Practice Address - Country:US
Practice Address - Phone:201-857-0888
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-06-20
Last Update Date:2015-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Single Specialty