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General NPI Number Information
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NPI Number | 1043580475
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Entity Type | Individual
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Provider Name | RYAN PARCO DPT
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Gender | Male
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Dates
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Enumeration Date | 01/02/2012
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Last Update Date | 01/02/2012
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Provider Practice Location Address
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Address Line | 400 INTERNATIONAL PKWY SUITE 300
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City | LAKE MARY
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State | FL
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Zip | 32746-5061
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Country | US
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Telephone | 407-833-8815
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Fax |
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Provider Business Mailing Address
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Address Line | 1 PIPER CRES
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City | BOWMANVILLE
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State | ONTARIO
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Zip | L1C0G3
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Country | CA
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 1212520
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License Number State | TX
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