Organization
SEJONGSA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SEJONG PARK CST AS-C (OWNER)
(888) 322-6432
Entity
Organization
Contact information
Practice address
51 ILLSLEY ST, PORTLAND, ME 04103-5110
(888) 322-6432
(888) 329-6432
Mailing address
51 ILLSLEY ST, PORTLAND, ME 04103-5110
(888) 322-6432
(888) 329-6432
Taxonomy
Speciality
Code
Description
License number
State
246ZC0007X
Surgical Assistant
Primary
—
ME
Other
Enumeration date
03/26/2008
Last updated
03/26/2008
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