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:
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Health care specialties

SpecialtyCodeLicense #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 11 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1295010627 NPPES
Michigan MEDICAID 1295010627

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