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General NPI Number Information
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NPI Number | 1376790998
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Entity Type | Individual
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Provider Name | MRS. MARY JUSTINE PARROTT-ALLEN
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Gender | Female
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Dates
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Enumeration Date | 08/26/2008
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Last Update Date | 08/25/2021
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Provider Practice Location Address
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Address Line | 1320 E BROADWAY ST STE A
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City | CAMPBELLSVILLE
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State | KY
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Zip | 42718-1596
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Country | US
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Telephone | 270-849-7207
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Fax | 270-465-0575
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Provider Business Mailing Address
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Address Line | 1320 E BROADWAY ST STE A
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City | CAMPBELLSVILLE
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State | KY
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Zip | 42718-1596
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Country | US
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Telephone | 270-849-7207
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Fax | 270-592-0402
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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 | 1744P3200X
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Taxonomy Name | Prosthetics Case Management
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License Number | 216378
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License Number State | KY
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