MEDICARE: MR. DANNY PARISH JR. BOCO

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	222Z00000X	Orthotist	C51166	MO

General Provider Information

NPI Number	:	1720943897
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. DANNY PARISH JR. BOCO

Provider Business Mailing Address
First Line	:	1355 RIDGE TOP DR
Second Line	:
City	:	FARMINGTON
State	:	MO
Zip	:	63640-7971
Country	:	US
Telephone Number	:	573-747-1144
Fax Number	:	573-747-1143

Provider Business Practice Location Address
First Line	:	728 SUNSET DR
Second Line	:
City	:	FARMINGTON
State	:	MO
Zip	:	63640
Country	:	US
Telephone Number	:	573-747-1144
Fax Number	:	573-747-1143

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/19/2025
Last Update Date	:	12/19/2025

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Directions to “ MR. DANNY PARISH JR. BOCO” Practice Location

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