Provider Demographics
NPI:1518673516
Name:DALL'AMORE, KYM C (DCM)
Entity Type:Individual
Prefix:
First Name:KYM
Middle Name:C
Last Name:DALL'AMORE
Suffix:
Gender:F
Credentials:DCM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:19685 PILOT KNOB RD STE 260
Mailing Address - Street 2:
Mailing Address - City:FARMINGTON
Mailing Address - State:MN
Mailing Address - Zip Code:55024-7238
Mailing Address - Country:US
Mailing Address - Phone:651-478-6988
Mailing Address - Fax:
Practice Address - Street 1:19685 PILOT KNOB RD STE 260
Practice Address - Street 2:
Practice Address - City:FARMINGTON
Practice Address - State:MN
Practice Address - Zip Code:55024-7238
Practice Address - Country:US
Practice Address - Phone:651-478-6988
Practice Address - Fax:651-478-6990
Is Sole Proprietor?:No
Enumeration Date:2023-01-24
Last Update Date:2023-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN2029171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist