Provider Demographics
NPI:1841461001
Name:KIM, DAL SOO (L AC)
Entity type:Individual
Prefix:MR
First Name:DAL
Middle Name:SOO
Last Name:KIM
Suffix:
Gender:M
Credentials:L AC
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Mailing Address - Street 1:6926 LITTLE RIVER TNPK
Mailing Address - Street 2:SUITE A
Mailing Address - City:ANNANDALE
Mailing Address - State:VA
Mailing Address - Zip Code:22003
Mailing Address - Country:US
Mailing Address - Phone:703-658-2222
Mailing Address - Fax:703-658-9499
Practice Address - Street 1:6926 LITTLE RIVER TPKE
Practice Address - Street 2:SUITE A
Practice Address - City:ANNANDALE
Practice Address - State:VA
Practice Address - Zip Code:22003-3246
Practice Address - Country:US
Practice Address - Phone:703-658-2222
Practice Address - Fax:703-658-9499
Is Sole Proprietor?:No
Enumeration Date:2008-03-17
Last Update Date:2008-03-17
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
VA0121000304171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist