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1831752864
JEA YOUNG PARK
DERBY, CT
NPI
1831752864
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
390200000X Student in an Organized Health Care Education/Training Program
Enumeration Date
2019-04-16
Last Update Date
2019-04-16
Business Address
JEA YOUNG PARK
130 DIVISION ST
DERBY, CT 06418-1326
Phone number: 203-732-7327
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Mailing Address
JEA YOUNG PARK
130 DIVISION ST
DERBY, CT 06418-1326
Phone number: 203-732-7327
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