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Individual

DAVID PARRELL

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man

Contact information

Practice address
4744 BLUE MOUNDS TRL, BLACK EARTH, WI 53515-9742
(608) 767-3413
Mailing address
4744 BLUE MOUNDS TRL, BLACK EARTH, WI 53515-9742
(608) 767-3413

Taxonomy

Speciality
Code
Description
License number
State
171W00000X
Contractor
Primary
12254-146
WI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0000000000113436
MASSAGE THERAPIST
WI
Enumeration date
03/08/2013
Last updated
03/08/2013
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