Provider Demographics
NPI:1770275679
Name:KIM, HYE SUNG (LAC)
Entity type:Individual
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First Name:HYE SUNG
Middle Name:
Last Name:KIM
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Gender:F
Credentials:LAC
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Mailing Address - Street 1:9161 LIBERIA AVE STE 102
Mailing Address - Street 2:
Mailing Address - City:MANASSAS
Mailing Address - State:VA
Mailing Address - Zip Code:20110-1724
Mailing Address - Country:US
Mailing Address - Phone:703-420-2722
Mailing Address - Fax:703-420-2681
Practice Address - Street 1:44121 HARRY BYRD HWY STE 145
Practice Address - Street 2:
Practice Address - City:ASHBURN
Practice Address - State:VA
Practice Address - Zip Code:20147-5667
Practice Address - Country:US
Practice Address - Phone:571-699-8428
Practice Address - Fax:703-420-2681
Is Sole Proprietor?:No
Enumeration Date:2023-05-22
Last Update Date:2023-05-22
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
VA0121001103171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist