Healthcare Provider Details

I. General information

NPI: 1437307196
Provider Name (Legal Business Name): PATRICIA A. PARKS P.T.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/05/2008
Last Update Date: 11/20/2024
Certification Date: 11/20/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

215 N CARLISLE AVE
SOMERTON AZ
85350
US

IV. Provider business mailing address

3720 E KING RANCH DR
YUMA AZ
85365-4682
US

V. Phone/Fax

Practice location:
  • Phone: 928-341-6041
  • Fax:
Mailing address:
  • Phone: 928-581-7010
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code2251P0200X
TaxonomyPediatric Physical Therapist
License Number3997
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: