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General NPI Number Information
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NPI Number | 1346669181
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Entity Type | Organization
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Legal Business Name | DR. MARGO PARKER OMD LLC
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Dates
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Enumeration Date | 04/09/2014
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Last Update Date | 04/09/2014
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Provider Practice Location Address
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Address Line | 1310 4TH STREET NORTH
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City | COEUR D ALENE
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State | ID
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Zip | 83814
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Country | US
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Telephone | 208-660-7363
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 490 2106 S. BIG BEAR ROAD
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City | COEUR D ALENE
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State | ID
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Zip | 83816-0490
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Country | US
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Telephone | 208-660-7363
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DR. MARGARET JORDAN PARKER
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Credential | OMD, LIC.AC.
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Telephone | 208-660-7363
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 171100000X
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Taxonomy Name | Acupuncturist
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License Number |
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License Number State |
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