Individual
KIMBERLY PARKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
P.T.
Contact information
Practice address
22 UPPER MAIN ST, SUITE 7, SHARON, CT 06069-2083
(860) 364-9840
(860) 364-1859
Mailing address
26 VALLEY RD, LAKEVILLE, CT 06039-2120
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
003087
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
080003087 CT 02
ANTHEM BC BS
CT
01
—
437133
MVP SPECIALIST
NY
01
—
Q34521
EMPIRE BC BS
NY
Enumeration date
04/26/2007
Last updated
07/08/2007
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