Individual
SE JONG PARK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CST AS-C
Contact information
Practice address
51 ILLSLEY ST, PORTLAND, ME 04103-5110
(207) 756-3621
(888) 329-6432
Mailing address
51 ILLSLEY ST, PORTLAND, ME 04103-5110
(207) 756-3621
(888) 329-6432
Taxonomy
Speciality
Code
Description
License number
State
246ZC0007X
Surgical Assistant
Primary
—
ME
Other
Enumeration date
02/27/2008
Last updated
02/27/2008
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