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1962671545
SE JONG PARK
PORTLAND, ME
NPI
1962671545
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
246ZC0007X Specialist/Technologist, Other, Surgical Assistant
Enumeration Date
2008-02-27
Last Update Date
2008-02-27
Business Address
-- SE JONG PARK CST AS-C
51 ILLSLEY ST
PORTLAND, ME 04103-5110
Phone number: 207-756-3621
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Mailing Address
-- SE JONG PARK CST AS-C
51 ILLSLEY ST
PORTLAND, ME 04103-5110
Phone number: 207-756-3621
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