Provider Demographics
NPI:1609982297
Name:KIM, THOMAS SEUNG (DPT)
Entity Type:Individual
Prefix:MR
First Name:THOMAS
Middle Name:SEUNG
Last Name:KIM
Suffix:
Gender:M
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:245 ROSMAN HWY
Mailing Address - Street 2:
Mailing Address - City:BREVARD
Mailing Address - State:NC
Mailing Address - Zip Code:28712-5708
Mailing Address - Country:US
Mailing Address - Phone:828-966-9036
Mailing Address - Fax:828-966-4538
Practice Address - Street 1:245 ROSMAN HWY
Practice Address - Street 2:
Practice Address - City:BREVARD
Practice Address - State:NC
Practice Address - Zip Code:28712-5708
Practice Address - Country:US
Practice Address - Phone:828-966-9036
Practice Address - Fax:828-966-4538
Is Sole Proprietor?:No
Enumeration Date:2006-08-23
Last Update Date:2014-11-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA2305204687225100000X
NC9748225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist