Individual
PAULA JEAN PARKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT
Contact information
Practice address
334 E MOUNT VERNON BLVD, MOUNT VERNON, MO 65712-2024
(417) 423-7409
(417) 423-7411
Mailing address
17134 BEL RAY PL, BELTON, MO 64012-5331
(816) 226-4011
(816) 524-6115
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
114999
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
MA4370057
MEDICARE PTAN
MO
Enumeration date
10/02/2006
Last updated
01/28/2014
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