Healthcare Provider Details

I. General information

NPI: 1083986954
Provider Name (Legal Business Name): DERIC D PARRISH PT, DPT
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/07/2012
Last Update Date: 10/01/2026
Certification Date: 10/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

732 VINE ST
MURRAY KY
42071-2630
US

IV. Provider business mailing address

732 VINE ST
MURRAY KY
42071-2630
US

V. Phone/Fax

Practice location:
  • Phone: 270-753-6477
  • Fax: 270-753-6478
Mailing address:
  • Phone: 270-753-6477
  • Fax: 270-753-6478

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number005999
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: