Individual
MARY RAINEY PARKER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PT
Contact information
Practice address
236 FLORIDA ST, SAINT SIMONS ISLAND, GA 31522-2636
(912) 242-3402
Mailing address
236 FLORIDA ST, SAINT SIMONS ISLAND, GA 31522-2636
(912) 242-3402
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT004503
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000687629E
—
GA
Enumeration date
05/24/2017
Last updated
07/21/2022
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