Individual
JIWON PARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
115 CASS AVE, WOONSOCKET, RI 02895-4731
(401) 769-4100
Mailing address
115 CASS AVE, WOONSOCKET, RI 02895-4731
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
TX
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
11/27/2023
Last updated
04/23/2026
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