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Organization

CHANUN PARK DO PA

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. CHANUN DUSTIN PARK D.O. (PRESIDENT)
(239) 369-4155
Entity
Organization

Contact information

Practice address
1220 BUSINESS WAY, UNIT 1, LEHIGH ACRES, FL 33936-6007
(239) 369-4155
(239) 369-1950
Mailing address
1220 BUSINESS WAY, UNIT 1, LEHIGH ACRES, FL 33936-6007
(239) 369-4155
(239) 369-1950

Taxonomy

Speciality
Code
Description
License number
State
261QP2300X
Primary Care Clinic/Center
Primary
OS8128
FL

Other

Enumeration date
09/17/2008
Last updated
11/24/2008
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