MEDICARE: DR. KEVIN DWAINE PARKER JR. DPT, LMT

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225100000X	Physical Therapist

General Provider Information

NPI Number	:	1043164627
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. KEVIN DWAINE PARKER JR. DPT, LMT

Provider Business Mailing Address
First Line	:	3697 PENNINGTON RD
Second Line	:
City	:	SHAKER HEIGHTS
State	:	OH
Zip	:	44120-5067
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	783 BETHEL RD
Second Line	:
City	:	COLUMBUS
State	:	OH
Zip	:	43214-1901
Country	:	US
Telephone Number	:	614-459-9409
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/23/2026
Last Update Date	:	02/23/2026

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Directions to “ DR. KEVIN DWAINE PARKER JR. DPT, LMT” Practice Location

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