Ki Soo Park
NPI #1205480779 in Lake Ridge, Virginia
Provider Information
- NPI Number
- 1205480779
- Entity Type
- Individual
- Name
- Ki Soo Park
- Gender
- Not Specified
- Sole Proprietor
- No
- Primary Specialty
- Physical Therapy Assistant
- Enumeration Date
- Aug 1, 2019
- Last Updated
- Aug 1, 2019
Practice Location
- Address
- 12825 MINNIEVILLE ROAD SUITE 201
- City
- Lake Ridge
- State
- Virginia
- ZIP Code
- 22192
- Phone
- (703) 647-3130
Specialties & Taxonomy Codes
| Specialty |
|---|
| Physical Therapy Assistant |
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