Individual
DR. JEREMY PARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PT, DPT, CSCS
Contact information
Practice address
110 W 6TH ST, OSWEGO, NY 13126-2507
(315) 345-1262
Mailing address
5511 LEGIONNAIRE DR APT 206, CICERO, NY 13039-3517
(315) 345-1262
Taxonomy
Speciality
Code
Description
License number
State
2251X0800X
Orthopedic Physical Therapist
Primary
052956
NY
Other
Enumeration date
09/23/2024
Last updated
09/23/2024
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