Individual
MRS. GRACE S PARK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LAC, PH.D
Contact information
Practice address
7122 BON VILLA CIR, LA PALMA, CA 90623-1167
(562) 754-1005
Mailing address
7122 BON VILLA CIR, LA PALMA, CA 90623-1167
(562) 754-1005
Taxonomy
Speciality
Code
Description
License number
State
171100000X
Acupuncturist
Primary
AC9620
CA
Other
Enumeration date
06/05/2007
Last updated
07/08/2007
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