Provider Demographics
NPI:1346569639
Name:KIM, HYUNG K (LAC)
Entity Type:Individual
Prefix:
First Name:HYUNG
Middle Name:K
Last Name:KIM
Suffix:
Gender:M
Credentials:LAC
Other - Prefix:
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Other - Middle Name:
Other - Last Name:
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Mailing Address - Street 1:7215 LITTLE RIVER TNPK
Mailing Address - Street 2:
Mailing Address - City:ANNANDALE
Mailing Address - State:VA
Mailing Address - Zip Code:22003
Mailing Address - Country:US
Mailing Address - Phone:703-750-9494
Mailing Address - Fax:703-750-2230
Practice Address - Street 1:7215 LITTLE RIVER TNPK
Practice Address - Street 2:
Practice Address - City:ANNANDALE
Practice Address - State:VA
Practice Address - Zip Code:22003
Practice Address - Country:US
Practice Address - Phone:703-750-9494
Practice Address - Fax:703-750-2230
Is Sole Proprietor?:Yes
Enumeration Date:2010-05-26
Last Update Date:2010-05-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0121000022171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist