Provider Demographics
NPI:1659816692
Name:KIM-S ACUPUNCTURE CLINIC INC.
Entity Type:Organization
Organization Name:KIM-S ACUPUNCTURE CLINIC INC.
Other - Org Name:SAGE WELLNESS CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DOCTOR OF ORIENTAL MEDICINE
Authorized Official - Prefix:DR
Authorized Official - First Name:JIN
Authorized Official - Middle Name:HO
Authorized Official - Last Name:KIM
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:407-539-3950
Mailing Address - Street 1:321 N MANGOUSTINE AVE
Mailing Address - Street 2:
Mailing Address - City:SANFORD
Mailing Address - State:FL
Mailing Address - Zip Code:32771-1098
Mailing Address - Country:US
Mailing Address - Phone:407-539-3950
Mailing Address - Fax:407-539-2661
Practice Address - Street 1:321 N MANGOUSTINE AVE
Practice Address - Street 2:
Practice Address - City:SANFORD
Practice Address - State:FL
Practice Address - Zip Code:32771-1098
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:2016-12-29
Last Update Date:2023-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Single Specialty