Individual
VIVIAN SEONGHWA PARK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
7726 GUNSTON PLZ UNIT 1417, LORTON, VA 22199-8066
(240) 481-8779
Mailing address
7726 GUNSTON PLZ UNIT 1417, LORTON, VA 22199-8066
(240) 481-8779
Taxonomy
Speciality
Code
Description
License number
State
335E00000X
Prosthetic/Orthotic Supplier
Primary
—
VA
335E00000X
Prosthetic/Orthotic Supplier
—
—
Other
Enumeration date
02/04/2025
Last updated
02/04/2025
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