Individual
MR. JAMES DARRYL PARKS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
FAODP
Contact information
Practice address
9605 GRAND RIVER AVE, DETROIT, MI 48204-2139
(313) 834-5930
(313) 834-4541
Mailing address
9605 GRAND RIVER AVE., DETROIT, MI 48204
(313) 834-5930
(313) 834-4541
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
820198
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
820198
—
MI
Enumeration date
02/20/2008
Last updated
02/20/2008
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