Pro Form Sports Medicine and Wellness Associates
NPI #1235432972 in Rutherford, New Jersey
Provider Information
- NPI Number
- 1235432972
- Entity Type
- Organization
- Organization Name
- Pro Form Sports Medicine and Wellness Associates
- Primary Specialty
- Emergency Medicine - Sports Medicine
- Enumeration Date
- Dec 20, 2010
- Last Updated
- Dec 20, 2010
Practice Location
- Address
- 201 ROUTE 17
- Address 2
- 11TH FLOOR
- City
- Rutherford
- State
- New Jersey
- ZIP Code
- 07070-2574
- Phone
- (201) 549-8846
Authorized Official
- Name
- DR. TAE KEUN PARK, MD
- Title
- PARTNER
- Phone
- (646) 489-5640
Specialties & Taxonomy Codes
| Specialty |
|---|
| Emergency Medicine - Sports Medicine — Sports Medicine |
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