Healthcare Provider Details

I. General information

NPI: 1649817289
Provider Name (Legal Business Name): LESLIE RENEE PARRISH DPT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/03/2019
Last Update Date: 12/03/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

215 DUNBAR CAVE RD STE A
CLARKSVILLE TN
37043-8850
US

IV. Provider business mailing address

260 KANNON DR
MADISON AL
35758-6610
US

V. Phone/Fax

Practice location:
  • Phone: 931-542-2739
  • Fax:
Mailing address:
  • Phone: 256-617-0438
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number12650
License Number StateTN
# 2
Primary TaxonomyN
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License NumberPTH9565
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: