Provider Demographics
NPI:1386751147
Name:PARKER, WILLIAM LOWELL (DC)
Entity type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:LOWELL
Last Name:PARKER
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:1320 S FRONTAGE RD
Mailing Address - Street 2:STE 102
Mailing Address - City:HASTINGS
Mailing Address - State:MN
Mailing Address - Zip Code:55033-2481
Mailing Address - Country:US
Mailing Address - Phone:651-480-2200
Mailing Address - Fax:651-480-1551
Practice Address - Street 1:1320 S FRONTAGE RD STE 102
Practice Address - Street 2:
Practice Address - City:HASTINGS
Practice Address - State:MN
Practice Address - Zip Code:55033-2481
Practice Address - Country:US
Practice Address - Phone:651-480-2200
Practice Address - Fax:651-480-1551
Is Sole Proprietor?:No
Enumeration Date:2006-08-25
Last Update Date:2019-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MNMN 3207111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN5C523PAOtherBCBS INDIVIDUAL NUMBAR
MN077814100OtherMN STATE HEALTHCARE
MN1386751147Medicare PIN