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General NPI Number Information
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NPI Number | 1437307196
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Entity Type | Individual
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Provider Name | PATRICIA A. PARKS P.T.
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Gender | Female
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Dates
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Enumeration Date | 09/05/2008
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Last Update Date | 11/20/2024
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Provider Practice Location Address
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Address Line | 215 N CARLISLE AVE
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City | SOMERTON
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State | AZ
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Zip | 85350
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Country | US
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Telephone | 928-341-6041
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Fax |
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Provider Business Mailing Address
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Address Line | 3720 E KING RANCH DR
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City | YUMA
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State | AZ
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Zip | 85365-4682
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Country | US
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Telephone | 928-581-7010
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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 | 2251P0200X
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Taxonomy Name | Pediatric Physical Therapist
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License Number | 3997
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License Number State | AZ
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Taxonomy #2
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number |
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License Number State |
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