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General NPI Number Information
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NPI Number | 1164394912
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Entity Type | Individual
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Provider Name | HUNTER BLAKE PARKER PTA
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Gender | Male
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Dates
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Enumeration Date | 09/22/2025
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Last Update Date | 09/22/2025
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Provider Practice Location Address
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Address Line | 4501 JACKSON ST STE D
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City | ALEXANDRIA
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State | LA
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Zip | 71303-2555
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Country | US
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Telephone | 318-704-0710
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Fax | 318-704-0711
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Provider Business Mailing Address
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Address Line | PO BOX 849
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City | JENNINGS
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State | LA
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Zip | 70546-0849
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Country | US
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Telephone | 337-824-8287
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Fax | 337-824-8290
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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 | 225200000X
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Taxonomy Name | Physical Therapy Assistant
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License Number | A10489
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License Number State | LA
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