Individual
DR. JAE YOUNG PARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
ACUPUNCTURIST
Contact information
Practice address
300 W HOSPITAL RD BLDG 3006TH, INTERDISCIPLINARY PAIN MANAGEMENT CENTER, FORT GORDON, GA 30905-5741
(706) 787-0716
(706) 787-0196
Mailing address
300 HOSPITAL RD, INTERDISCIPLINARY PAIN MANAGEMENT CENTER, FORT GORDON, GA 30905-5741
(706) 787-8322
(706) 787-0196
Taxonomy
Speciality
Code
Description
License number
State
171100000X
Acupuncturist
Primary
11226
CA
Other
Enumeration date
10/18/2006
Last updated
07/28/2015
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