Individual
WILLIAM PARKS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
12166 OLD BIG BEND RD, KIRKWOOD, MO 63122-6844
(314) 822-8888
Mailing address
12166 OLD BIG BEND RD, KIRKWOOD, MO 63122-6844
(314) 822-8888
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
2021049879
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2021049879
STATE LICENSE
MO
Enumeration date
01/13/2022
Last updated
01/13/2022
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