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Individual
JOSEPH PARK
Active
Individual
JOSEPH PARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PT
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
070-016785
IL
225100000X
Physical Therapist
Primary
36571
CA
Other
Enumeration date
12/08/2008
Last updated
07/20/2010
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