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General NPI Number Information
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NPI Number | 1427270024
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Entity Type | Individual
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Provider Name | LAWRENCE WAYNE PARKS JR. D.C.
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Gender | Male
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Dates
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Enumeration Date | 05/03/2007
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Last Update Date | 08/31/2015
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Provider Practice Location Address
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Address Line | 1321 S RAINBOW BLVD SUITE 201
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City | LAS VEGAS
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State | NV
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Zip | 89146-9066
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Country | US
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Telephone | 832-580-2465
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Fax |
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Provider Business Mailing Address
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Address Line | 6124 CRYSTAL CASCADE ST
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City | LAS VEGAS
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State | NV
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Zip | 89130-1531
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Country | US
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Telephone | 832-561-5803
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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 | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | 9035
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License Number State | TX
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