Organization
NEUROLOGICAL CLINIC, SC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. BYUNG H. PARK MD (PRESIDENT)
(262) 880-5525
Entity
Organization
Contact information
Practice address
7700 LITTLE RIVER TPKE STE 605, ANNANDALE, VA 22003-2400
(571) 620-7159
(571) 620-7571
Mailing address
5525 GREEN BAY RD, KENOSHA, WI 53144-3737
(262) 657-2060
(262) 657-2069
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
—
—
Other
Enumeration date
09/10/2019
Last updated
09/10/2019
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