Individual
ADAM PARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
451 E 1000 S STE C, PLEASANT GROVE, UT 84062-3738
(385) 329-5958
Mailing address
451 E 1000 S STE C, PLEASANT GROVE, UT 84062-3700
(385) 329-5958
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
—
Other
Enumeration date
01/31/2019
Last updated
01/31/2019
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