Individual
JONGDUG PARK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
826 LARCHMONT ACRES APT A, LARCHMONT, NY 10538-7378
(917) 715-5115
Mailing address
826 LARCHMONT ACRES APT A, LARCHMONT, NY 10538-7378
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
X012153
NY
Other
Enumeration date
08/06/2012
Last updated
08/06/2012
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