Provider Demographics
NPI:1932413861
Name:KIM, JAMES CHONGHYUK (DC, PC)
Entity Type:Individual
Prefix:DR
First Name:JAMES
Middle Name:CHONGHYUK
Last Name:KIM
Suffix:
Gender:M
Credentials:DC, PC
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:3917 OLD LEE HWY
Mailing Address - Street 2:SUITE #11A
Mailing Address - City:FAIRFAX
Mailing Address - State:VA
Mailing Address - Zip Code:22030-2431
Mailing Address - Country:US
Mailing Address - Phone:703-273-2792
Mailing Address - Fax:703-273-1037
Practice Address - Street 1:3917 OLD LEE HWY
Practice Address - Street 2:SUITE #11A
Practice Address - City:FAIRFAX
Practice Address - State:VA
Practice Address - Zip Code:22030-2431
Practice Address - Country:US
Practice Address - Phone:703-273-2792
Practice Address - Fax:703-273-1037
Is Sole Proprietor?:No
Enumeration Date:2010-08-03
Last Update Date:2012-10-05
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
VA0104556789111N00000X
MD03630111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor