Individual
JOHNNY L PARKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
4234 9TH AVENUE CIR S, FARGO, ND 58103-2090
(701) 318-8527
Mailing address
4234 9TH AVENUE CIR S, FARGO, ND 58103-2090
(701) 318-8527
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
—
—
3747A0650X
Attendant Care Provider
—
—
3747P1801X
Personal Care Attendant
—
—
374U00000X
Home Health Aide
—
—
376J00000X
Homemaker
—
—
Other
Enumeration date
10/23/2012
Last updated
01/16/2014
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