Individual
MALIA SHAE PAK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
BSEXSC
Contact information
Practice address
500 MAINE ST APT 308, QUINCY, IL 62301-3949
(816) 914-4385
Mailing address
500 MAINE ST APT 308, QUINCY, IL 62301-3949
(816) 914-4385
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
—
—
Other
Enumeration date
11/10/2023
Last updated
11/10/2023
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