Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111N00000X | Chiropractor | CHIR006201 | GA |
NPI | 1003981416 |
---|---|
Provider Name | Dr. John Parlier |
First Address | Lake City, GA 30260-3553 |
Second Address | Lake City, GA 30260-3553 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 21/11/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
U86888 | (02) | GA |