Provider Demographics
NPI:1952875817
Name:KIM'S CHIROPRACTIC CLINIC INC
Entity Type:Organization
Organization Name:KIM'S CHIROPRACTIC CLINIC INC
Other - Org Name:BEST SPINE CLINIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CHIROPRACTOR/PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:TAE YONG
Authorized Official - Middle Name:
Authorized Official - Last Name:KIM
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:425-264-3054
Mailing Address - Street 1:4509 TALBOT ROAD SOUTH
Mailing Address - Street 2:SUITE 104
Mailing Address - City:RENTON
Mailing Address - State:WA
Mailing Address - Zip Code:98055-5294
Mailing Address - Country:US
Mailing Address - Phone:425-264-3054
Mailing Address - Fax:425-207-8546
Practice Address - Street 1:4509 TALBOT ROAD SOUTH
Practice Address - Street 2:SUITE 104
Practice Address - City:RENTON
Practice Address - State:WA
Practice Address - Zip Code:98055-5294
Practice Address - Country:US
Practice Address - Phone:425-264-3054
Practice Address - Fax:425-207-8546
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-01-14
Last Update Date:2019-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty