Individual
CARISSA MICHELLE PARKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DPT
Contact information
Practice address
1254 SE CENTURY DR, LEES SUMMIT, MO 64081-3286
(480) 452-5302
Mailing address
4900 S ARROWHEAD DR, STE B, INDEPENDENCE, MO 64055-6952
(816) 795-6999
(816) 795-3366
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
2013023363
MO
225100000X
Physical Therapist
—
MO
2251X0800X
Orthopedic Physical Therapist
—
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1194166116
PHYSICAL THERAPIST
MO
05
—
1194166116
—
MO
Enumeration date
07/08/2013
Last updated
01/23/2019
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