Individual
SE HUN PARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
ATC
Contact information
Practice address
3401 W GORE BLVD, LAWTON, OK 73505-6332
(580) 355-8620
Mailing address
3401 W GORE BLVD, LAWTON, OK 73505-6332
(580) 355-8620
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
2015022932
MO
363A00000X
Physician Assistant
Primary
—
—
Other
Enumeration date
08/19/2015
Last updated
12/20/2024
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