Individual
ELAINE PARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
X
Contact information
Practice address
171 ASHLEY AVE, CHARLESTON, SC 29425-8908
(843) 792-1414
Mailing address
150 BEE ST APT 502, CHARLESTON, SC 29401-5704
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
01/27/2026
Last updated
01/27/2026
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