Individual
MR. JERRELL PARKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
11200 GOVERNOR MANLY WAY, RALEIGH, NC 27614-8599
(919) 562-9410
Mailing address
2213 WOODWYCK WAY, RALEIGH, NC 27604-6128
(919) 884-1335
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
A4596
NC
Other
Enumeration date
08/07/2020
Last updated
08/07/2020
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