Healthcare Provider Details

I. General information

NPI: 1831969187
Provider Name (Legal Business Name): PAUL ALAN PARRISH DC
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/08/2024
Last Update Date: 01/08/2024
Certification Date: 01/08/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

300 OZARK TRAIL DR STE 105
ELLISVILLE MO
63011-2156
US

IV. Provider business mailing address

594 BRIDGEBEND RD
MANCHESTER MO
63021-6704
US

V. Phone/Fax

Practice location:
  • Phone: 636-207-6600
  • Fax:
Mailing address:
  • Phone: 484-366-6324
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number2024000511
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: