Individual
DR. BRENT D PARRY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DPM
Contact information
Practice address
180 S MAIN ST, CANTON, IL 61520-2608
(309) 647-0201
(309) 649-6880
Mailing address
180 S MAIN ST, CANTON, IL 61520-2608
(309) 647-0201
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
016004894
IL
213ES0103X
Foot & Ankle Surgery Podiatrist
Primary
016004894
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
016004894
STATE LICENSE
IL
Enumeration date
07/19/2005
Last updated
04/08/2021
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