Provider Demographics
NPI:1295258838
Name:OH, SUNGMIN
Entity type:Individual
Prefix:
First Name:SUNGMIN
Middle Name:
Last Name:OH
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2066, SEOBU-RO, JANGAN-GU
Mailing Address - Street 2:SUSUNG-GWAN, SPORT PSYCHOLOGY LAB. (#05120)
Mailing Address - City:SUWON-SI
Mailing Address - State:GYEONGGI-DO
Mailing Address - Zip Code:16419
Mailing Address - Country:KR
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2066, SEOBU-RO, JANGAN-GU
Practice Address - Street 2:SUSUNGGWAN #05120
Practice Address - City:SUWON-SI
Practice Address - State:GYEONGGI-DO
Practice Address - Zip Code:16419
Practice Address - Country:KR
Practice Address - Phone:031-705-6922
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-07-25
Last Update Date:2017-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer