Individual
STACY PARKS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PT
Contact information
Practice address
4720 CAIRO DR NE, SY JACKSON ES, ALBUQUERQUE, NM 87111-2617
(505) 296-9536
Mailing address
4720 CAIRO DR NE, SY JACKSON ES, ALBUQUERQUE, NM 87111-2617
(505) 296-9536
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
858
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
H 3023
—
NM
Enumeration date
03/12/2007
Last updated
07/09/2007
About Stedi
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