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Individual

KATHY PARKER

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
2828 SIGHTSEEING RD, FT BENNING, GA 31905
(706) 545-4627
Mailing address
3307 HUMMINGBIRD CT, PHENIX CITY, AL 36867-7127
(706) 536-7651

Taxonomy

Speciality
Code
Description
License number
State
125J00000X
Dental Therapist
Primary
XXXXX
KY

Other

Enumeration date
06/07/2016
Last updated
06/07/2016
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