Healthcare Provider Details
I. General information
NPI: 1982773495
Provider Name (Legal Business Name): JEFFRY T PARKER DC
Entity Type: Individual
Gender: Male
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 11/07/2006
Last Update Date: 07/20/2010
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
6825 E HAMPDEN AVE STE 100
DENVER CO
80224-3000
US
IV. Provider business mailing address
6825 E HAMPDEN AVE STE 100
DENVER CO
80224-3000
US
V. Phone/Fax
- Phone: 303-758-0224
- Fax: 303-758-2633
- Phone: 303-758-0224
- Fax: 303-758-2633
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 111N00000X |
| Taxonomy | Chiropractor |
| License Number | 2329 |
| License Number State | CO |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 111NN1001X |
| Taxonomy | Nutrition Chiropractor |
| License Number | 2329 |
| License Number State | CO |
| # 3 | |
| Primary Taxonomy | N |
| Taxonomy Code | 111NS0005X |
| Taxonomy | Sports Physician Chiropractor |
| License Number | 2329 |
| License Number State | CO |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: