Individual
JO EUN PARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1835 N MAIN ST, ROSWELL, NM 88201-5168
(575) 624-0423
Mailing address
1600 N SYCAMORE AVE APT 512, ROSWELL, NM 88201-8947
(617) 991-6694
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
RP00009395
NM
Other
Enumeration date
10/15/2020
Last updated
10/15/2020
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