Provider Demographics
NPI:1922482942
Name:KIMS ACUPUNCTURE & HERBAL MEDS
Entity Type:Organization
Organization Name:KIMS ACUPUNCTURE & HERBAL MEDS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/LAC/OMD
Authorized Official - Prefix:
Authorized Official - First Name:HYEON
Authorized Official - Middle Name:JOO
Authorized Official - Last Name:KIM
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:801-287-9559
Mailing Address - Street 1:153 E 4370 S STE 16
Mailing Address - Street 2:
Mailing Address - City:MURRAY
Mailing Address - State:UT
Mailing Address - Zip Code:84107-2608
Mailing Address - Country:US
Mailing Address - Phone:801-287-9559
Mailing Address - Fax:
Practice Address - Street 1:153 E 4370 S STE 16
Practice Address - Street 2:
Practice Address - City:MURRAY
Practice Address - State:UT
Practice Address - Zip Code:84107-2608
Practice Address - Country:US
Practice Address - Phone:801-287-9559
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-07-20
Last Update Date:2015-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Single Specialty