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NPI Code Detail

MEDICARE: YUNJAE PARK DC

MEDICARE: YUNJAE PARK DC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1111N00000XChiropractor8946AZ

General Provider Information

NPI Number : 1366953200
Entity Type Code : Individual
Provider Name (Legal Business Name) : YUNJAE PARK DC
Provider Business Mailing Address
First Line : 4920 W THUNDERBIRD RD STE 112
Second Line :
City : GLENDALE
State : AZ
Zip : 85306-4906
Country : US
Telephone Number : 623-487-3444
Fax Number :
Provider Business Practice Location Address
First Line : 4920 W THUNDERBIRD RD STE 112
Second Line :
City : GLENDALE
State : AZ
Zip : 85306-4906
Country : US
Telephone Number : 623-487-3444
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/18/2017
Last Update Date : 11/19/2020

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Directions to “ YUNJAE PARK DC” Practice Location

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