Individual
TAI PARKER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
4020 SARA DR APT 104, UNIONTOWN, OH 44685-8159
(330) 472-2115
Mailing address
4020 SARA DR APT 104, UNIONTOWN, OH 44685-8159
(330) 472-2115
Taxonomy
Speciality
Code
Description
License number
State
332BC3200X
Customized Equipment (DME)
Primary
219797
OH
Other
Enumeration date
03/27/2015
Last updated
03/27/2015
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