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NPI Code Detail

MEDICARE: DR. KATIE PARKS D.C.

MEDICARE:  DR. KATIE  PARKS  D.C.
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
1111N00000XChiropractor3863SC

General Provider Information

NPI Number : 1861840373
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. KATIE PARKS D.C.
Provider Business Mailing Address
First Line : 1221 BOWER PKWY
Second Line :
City : COLUMBIA
State : SC
Zip : 29212-3732
Country : US
Telephone Number : 803-708-4258
Fax Number :
Provider Business Practice Location Address
First Line : 1221 BOWER PKWY
Second Line :
City : COLUMBIA
State : SC
Zip : 29212-3732
Country : US
Telephone Number : 803-708-4258
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/25/2016
Last Update Date : 05/25/2016

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Directions to “ DR. KATIE PARKS D.C.” Practice Location

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