Individual
KWON PARK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PHARMD
Contact information
Practice address
1555 NORTHWAY DR STE 200, SAINT CLOUD, MN 56303-4913
(320) 240-3102
Mailing address
1555 NORTHWAY DR STE 200, SAINT CLOUD, MN 56303-4913
(320) 240-3102
(320) 240-3164
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
125656
MN
1835P2201X
Ambulatory Care Pharmacist
125656
MN
Other
Enumeration date
07/14/2022
Last updated
07/14/2022
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