MEDICARE: LYNDA LOUISE PARRISH

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	174400000X	Specialist

General Provider Information

NPI Number	:	1063960748
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LYNDA LOUISE PARRISH

Provider Business Mailing Address
First Line	:	842 N HIGHLAND AVE NE STE 223
Second Line	:
City	:	ATLANTA
State	:	GA
Zip	:	30306-4530
Country	:	US
Telephone Number	:	404-456-1061
Fax Number	:	573-230-7813

Provider Business Practice Location Address
First Line	:	842 N HIGHLAND AVE NE STE 223
Second Line	:
City	:	ATLANTA
State	:	GA
Zip	:	30306-4530
Country	:	US
Telephone Number	:	404-456-1061
Fax Number	:	573-230-7813

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

Provider Enumeration Date	:	09/12/2016
Last Update Date	:	09/12/2016

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Directions to “ LYNDA LOUISE PARRISH ” Practice Location

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