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General NPI Number Information
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NPI Number | 1821161035
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Entity Type | Individual
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Provider Name | YOOJIN PARK DPT
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Gender | Female
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Dates
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Enumeration Date | 11/16/2006
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Last Update Date | 06/10/2010
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Provider Practice Location Address
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Address Line | 195 FALCON DRIVE
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City | FREDERICKSBURG
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State | VA
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Zip | 22408
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Country | US
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Telephone | 540-735-0260
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Fax | 540-735-0262
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Provider Business Mailing Address
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Address Line | 1203 ANDERSON ST
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City | FREDERICKSBURG
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State | VA
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Zip | 22401-2630
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Country | US
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Telephone | 540-735-0260
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Fax | 540-735-0262
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number |
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License Number State | VA
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