Individual
MRS. PERMELIA ANN PARKER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CSA
Contact information
Practice address
2359 NOEL C CONAWAY RD, GUYTON, GA 31312-6114
(912) 728-6753
Mailing address
PO BOX 471, BLOOMINGDALE, GA 31302-0471
(912) 728-6753
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
04-228
GA
Other
Enumeration date
12/20/2006
Last updated
07/08/2007
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