Individual
MRS. TRISHA PARK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
9108 HARLEQUIN CIR, FREDERICK, CO 80504-9753
(720) 841-8744
Mailing address
9108 HARLEQUIN CIR, FREDERICK, CO 80504-9753
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
163714
CO
Other
Enumeration date
03/31/2017
Last updated
03/31/2017
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