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Individual

MR. JUNE PARK

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
L.AC

Contact information

Practice address
5550 STERRETT PL STE 303, COLUMBIA, MD 21044-2643
(410) 997-0390
Mailing address
7758 MAYFAIR CIR # B, ELLICOTT CITY, MD 21043-6970
(443) 360-2766

Taxonomy

Speciality
Code
Description
License number
State
171100000X
Acupuncturist
Primary
U02390
MD

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
166298
NATIONAL CERTIFICATION COMMISSION FOR ACUPUNCTURE AND ORIENTAL MEDICINE
Enumeration date
10/24/2018
Last updated
01/27/2019
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