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General NPI Number Information
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NPI Number | 1891997714
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Entity Type | Individual
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Provider Name | CALVIN H PARKS
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Gender | Male
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Dates
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Enumeration Date | 06/04/2007
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Last Update Date | 05/16/2008
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Provider Practice Location Address
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Address Line | 1321 HUNTSVILLE HWY
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City | FAYETTEVILLE
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State | TN
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Zip | 37334
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Country | US
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Telephone | 931-433-4478
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Fax | 931-433-4478
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Provider Business Mailing Address
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Address Line | 1321 HUNTSVILLE HWY
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City | FAYETTEVILLE
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State | TN
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Zip | 37334-3603
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Country | US
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Telephone | 931-433-4478
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Fax | 931-433-4478
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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 | DC0000000133
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License Number State | TN
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