Provider Demographics
NPI:1700408044
Name:BON WELLNESS KIM PC
Entity Type:Organization
Organization Name:BON WELLNESS KIM PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:KYOUNG
Authorized Official - Middle Name:HWAN
Authorized Official - Last Name:KIM
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:410-294-9499
Mailing Address - Street 1:7901 GREENTREE RD
Mailing Address - Street 2:
Mailing Address - City:BETHESDA
Mailing Address - State:MD
Mailing Address - Zip Code:20817-1301
Mailing Address - Country:US
Mailing Address - Phone:410-294-9499
Mailing Address - Fax:
Practice Address - Street 1:7901 GREENTREE RD
Practice Address - Street 2:
Practice Address - City:BETHESDA
Practice Address - State:MD
Practice Address - Zip Code:20817-1301
Practice Address - Country:US
Practice Address - Phone:410-294-9499
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-05-09
Last Update Date:2020-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Single Specialty