Individual
JAE Y PARK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
RN
Contact information
Practice address
1103 10TH ST NW, ROCHESTER, MN 55901-1756
(507) 358-9114
Mailing address
1103 10TH ST NW, ROCHESTER, MN 55901-1756
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
2077426
MN
Other
Enumeration date
09/02/2017
Last updated
09/02/2017
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