MEDICARE: RASHEEM PARKS

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	225400000X	Rehabilitation Practitioner		NV

General Provider Information

NPI Number	:	1720602303
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	RASHEEM PARKS

Provider Business Mailing Address
First Line	:	2951 SIENA HEIGHTS DR
Second Line	:
City	:	HENDERSON
State	:	NV
Zip	:	89052-3872
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	3925 N MLK BLVD STE 212
Second Line	:
City	:	NORTH LAS VEGAS
State	:	NV
Zip	:	89032-7676
Country	:	US
Telephone Number	:	702-647-0242
Fax Number	:

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

Provider Enumeration Date	:	05/30/2020
Last Update Date	:	05/30/2020

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Directions to “ RASHEEM PARKS ” Practice Location

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