Organization
KELLI L. PARKS, OD, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. KELLI L PARKS OD (OPTOMETRIST)
(850) 585-8830
Entity
Organization
Contact information
Practice address
740 BEAL PKWY NW, FORT WALTON BEACH, FL 32547-3002
(850) 585-8830
Mailing address
PO BOX 874, NICEVILLE, FL 32588-0874
(850) 585-8830
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
OPC3149
FL
Other
Enumeration date
11/30/2012
Last updated
11/30/2012
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