Ki Soo Park
Ki Soo Park is a Physical Therapy Assistant in Lake Ridge, Virginia. Registered with an NPI since 2019.
- In the registry since
- 2019
Practice location Address checks out
12825 Minnieville Rd Ste 201Lake Ridge, VA 22192
Phone: (703) 647-3130
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Pin is approximate — placed at the ZIP-code centre, not the exact door.
Specialties & licences
| Physical Therapy Assistant (primary) | Taxonomy 225200000X |
|---|
Record details
| NPI number | 1205480779 |
|---|---|
| Entity type | Individual (Type 1) |
| Gender | Male |
| Sole proprietor | No |
| NPI enumerated | August 1, 2019 |
| Last updated in NPPES | August 1, 2019 |
| Mailing address | 4610 Lawn Ct, Fairfax, VA 22032 |
Other providers in Lake Ridge
-
Jennifer Johnson
12825 Minnieville Rd Ste 201, Lake Ridge, VA 22192-3602 · (571) 470-8776
-
Jonathan Phuong
12825 Minnieville Rd Ste 201, Lake Ridge, VA 22192-3602 · (703) 647-3130