Provider Demographics
NPI:1356853659
Name:KIM,JIN
Entity Type:Organization
Organization Name:KIM,JIN
Other - Org Name:KIM-S ACUPUNCTURE CLINIC, INC.
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JIN
Authorized Official - Middle Name:H
Authorized Official - Last Name:KIM
Authorized Official - Suffix:
Authorized Official - Credentials:AP
Authorized Official - Phone:407-539-3950
Mailing Address - Street 1:400 W FAIRBANKS AVE STE B
Mailing Address - Street 2:
Mailing Address - City:WINTER PARK
Mailing Address - State:FL
Mailing Address - Zip Code:32789-5084
Mailing Address - Country:US
Mailing Address - Phone:407-539-3950
Mailing Address - Fax:407-539-2661
Practice Address - Street 1:400 W FAIRBANKS AVE STE B
Practice Address - Street 2:
Practice Address - City:WINTER PARK
Practice Address - State:FL
Practice Address - Zip Code:32789-5084
Practice Address - Country:US
Practice Address - Phone:407-539-3950
Practice Address - Fax:407-539-2661
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-10-26
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Multi-Specialty