Individual
JOSHUA RIDIKAS PARKER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
168 EBENEZER CHURCH RD, FAYETTEVILLE, GA 30215-5201
(770) 639-7949
Mailing address
168 EBENEZER CHURCH RD, FAYETTEVILLE, GA 30215-5201
(770) 639-7949
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
AT002879
GA
Other
Enumeration date
02/03/2021
Last updated
02/03/2021
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