MEDICARE: CHRIS PARKE R.D.

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	133V00000X	Registered Dietitian	KY1533	KY

General Provider Information

NPI Number	:	1861892481
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CHRIS PARKE R.D.

Provider Business Mailing Address
First Line	:	1095 FOUR MILE RD
Second Line	:
City	:	RICHMOND
State	:	KY
Zip	:	40475-9260
Country	:	US
Telephone Number	:	859-582-9059
Fax Number	:

Provider Business Practice Location Address
First Line	:	200 BOONE WAY
Second Line	:
City	:	RICHMOND
State	:	KY
Zip	:	40475-9444
Country	:	US
Telephone Number	:	859-582-9059
Fax Number	:

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

Provider Enumeration Date	:	09/02/2014
Last Update Date	:	09/02/2014

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Directions to “ CHRIS PARKE R.D.” Practice Location

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