Individual
BOYOUNG PARK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
4355 S NATIONAL AVE APT 905, SPRINGFIELD, MO 65810
(402) 213-9605
Mailing address
4355 S NATIONAL AVE APT 905, SPRINGFIELD, MO 65810-2655
(402) 213-9605
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
—
—
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
12/07/2017
Last updated
07/27/2018
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