Provider Demographics
NPI:1346089562
Name:PARKER, JUSTIN (PT, DPT)
Entity type:Individual
Prefix:
First Name:JUSTIN
Middle Name:
Last Name:PARKER
Suffix:
Gender:M
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2180 CLEARWATER LN
Mailing Address - Street 2:
Mailing Address - City:CAMDEN
Mailing Address - State:SC
Mailing Address - Zip Code:29020-9438
Mailing Address - Country:US
Mailing Address - Phone:865-384-0318
Mailing Address - Fax:
Practice Address - Street 1:933 DECATUR PIKE
Practice Address - Street 2:
Practice Address - City:ATHENS
Practice Address - State:TN
Practice Address - Zip Code:37303-3037
Practice Address - Country:US
Practice Address - Phone:423-405-0013
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-05-20
Last Update Date:2024-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist