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Individual

SO YUN PARK GRACE

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MD

Contact information

Practice address
2734 N 61ST ST, OMAHA, NE 68104-4020
(402) 553-0222
(402) 553-5092
Mailing address
2734 N 61ST ST, OMAHA, NE 68104-4020
(402) 553-0222
(402) 553-5092

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
26392
NE

Other

Enumeration date
08/22/2008
Last updated
08/28/2019
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