Jong Park

NPI #1205460847 in Mount Pleasant, Wisconsin

Provider Information

NPI Number: 1205460847
Entity Type: Individual
Name: Jong Park
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Pharmacist
Enumeration Date: Feb 22, 2020
Last Updated: Feb 22, 2020

Practice Location

Address: 4901 SPRING ST
City: Mount Pleasant
State: Wisconsin
ZIP Code: 53406-2901
Phone: (262) 886-9643

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Pharmacist	183500000X	Primary

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