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General NPI Number Information
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NPI Number | 1124627286
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Entity Type | Individual
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Provider Name | KIRSTEN RENE PARKER
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Gender | Female
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Dates
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Enumeration Date | 10/20/2020
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Last Update Date | 10/20/2020
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Provider Practice Location Address
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Address Line | 750 COUNTY ROAD 234 BLDG 1
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City | GEORGETOWN
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State | TX
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Zip | 78633-4426
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Country | US
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Telephone | 512-556-0211
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Fax |
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Provider Business Mailing Address
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Address Line | 204 N PENELOPE ST STE C
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City | BELTON
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State | TX
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Zip | 76513-3127
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Country | US
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Telephone | 512-556-0211
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Fax | 512-556-0211
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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 | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | 14310
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License Number State | TX
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