Provider Demographics
NPI:1306444955
Name:KIM, DONGYOUNG
Entity type:Individual
Prefix:
First Name:DONGYOUNG
Middle Name:
Last Name:KIM
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5500 DTC PKWY APT 511
Mailing Address - Street 2:
Mailing Address - City:GREENWOOD VILLAGE
Mailing Address - State:CO
Mailing Address - Zip Code:80111-3166
Mailing Address - Country:US
Mailing Address - Phone:347-343-0645
Mailing Address - Fax:
Practice Address - Street 1:14001 E ILIFF AVE STE 215
Practice Address - Street 2:
Practice Address - City:AURORA
Practice Address - State:CO
Practice Address - Zip Code:80014-1426
Practice Address - Country:US
Practice Address - Phone:303-341-2277
Practice Address - Fax:303-341-7722
Is Sole Proprietor?:Yes
Enumeration Date:2020-10-15
Last Update Date:2022-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty