Organization
STRIVEMD WELLNESS & KETAMINE PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DANNY PARK MD (MD)
(419) 509-3726
Entity
Organization
Contact information
Practice address
527 CENTRE VIEW BLVD, CRESTVIEW HILLS, KY 41017-3444
(859) 415-0056
Mailing address
527 CENTRE VIEW BLVD, CRESTVIEW HILLS, KY 41017-3444
(859) 415-0056
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
—
—
207LP2900X
Pain Medicine (Anesthesiology) Physician
Primary
—
—
Other
Enumeration date
12/15/2020
Last updated
12/15/2020
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