Individual
MR. JASON YISU PARK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
P.T
Contact information
Practice address
3604 GALLEY RD, SUITE 200, COLORADO SPRINGS, CO 80909-4302
(719) 550-4613
(719) 375-8426
Mailing address
3604 GALLEY RD., SUITE 200, COLORADO SPRINGS, CO 80909-4301
(719) 550-4613
(719) 375-8426
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
8470
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
42722241
—
CO
Enumeration date
07/03/2007
Last updated
02/02/2016
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