Kim, Jennifer J.
Kim, Jennifer J. is an individual health care provider with primary practice located at 118 Cass Ave , Mount Clemens MI 48043-2204. She recently has only one registered license in Eye and Vision Services Providers / Optometrist, which is considered as her primary health care specialty. Kim, Jennifer J. can be contacted via phone (586) 468-7370.Contact Information
Primary practice address
118 Cass Ave
Mount Clemens MI 48043-2204
Phone: (586) 468-7370
Fax:
Website:
Health care specialties
Specialty | Code | License # | State |
---|---|---|---|
Eye and Vision Services Providers / Optometrist | 152W00000X | 14259 | California |
Eye and Vision Services Providers / Optometrist | 152W00000X | 4901004914 | Michigan |
Profile Details
NPI number | 1295010627 |
---|---|
LBN Legal business name | Kim, Jennifer J. |
Credentials | Doctor of Optometry (OD) |
Entity | Individual |
Sole proprietor 1 | No |
Enumeration date | Oct 17th, 2011 |
Last updated | Nov 5th, 2015 - about 9 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
State | Type | Number | Issuer |
---|---|---|---|
All States | NPI | 1295010627 | NPPES |
Michigan | MEDICAID | 1295010627 |
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