Healthcare Provider Details

I. General information

NPI: 1316637556
Provider Name (Legal Business Name): CHRISTOPHER PHILLIP PARRY LSW
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/10/2023
Last Update Date: 06/17/2025
Certification Date: 06/17/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8888 N GRAND CANYON DR UNIT 2003
LAS VEGAS NV
89166-6816
US

IV. Provider business mailing address

8888 N GRAND CANYON DR UNIT 2003
LAS VEGAS NV
89166-6816
US

V. Phone/Fax

Practice location:
  • Phone: 801-661-6658
  • Fax:
Mailing address:
  • Phone: 801-661-6658
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code225400000X
TaxonomyRehabilitation Practitioner
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number6970-M
License Number StateNV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: