Healthcare Provider Details

I. General information

NPI: 1184550931
Provider Name (Legal Business Name): DYLAN MICHAEL PARKS DC
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/19/2026
Last Update Date: 06/19/2026
Certification Date: 06/19/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

375 SWAINS POND AVE
MELROSE MA
02176-5811
US

IV. Provider business mailing address

375 SWAINS POND AVE
MELROSE MA
02176-5811
US

V. Phone/Fax

Practice location:
  • Phone: 832-764-1147
  • Fax:
Mailing address:
  • Phone: 832-764-1147
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License NumberCHI5204
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: