Provider Demographics
NPI:1619063708
Name:KIM, JUYHUN (PHYSICAL THERAPIST)
Entity Type:Individual
Prefix:MISS
First Name:JUYHUN
Middle Name:
Last Name:KIM
Suffix:
Gender:F
Credentials:PHYSICAL THERAPIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 472
Mailing Address - Street 2:
Mailing Address - City:MAKAWAO
Mailing Address - State:HI
Mailing Address - Zip Code:96768-0472
Mailing Address - Country:US
Mailing Address - Phone:808-856-9890
Mailing Address - Fax:808-427-4202
Practice Address - Street 1:153 E KAMEHAMEHA AVE STE 104
Practice Address - Street 2:
Practice Address - City:KAHULUI
Practice Address - State:HI
Practice Address - Zip Code:96732-3424
Practice Address - Country:US
Practice Address - Phone:808-856-9890
Practice Address - Fax:808-427-4202
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-05
Last Update Date:2020-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HI2598225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist