Provider Demographics
NPI:1902455678
Name:PARRA, PARKER ALLEN (DPT)
Entity type:Individual
Prefix:
First Name:PARKER
Middle Name:ALLEN
Last Name:PARRA
Suffix:
Gender:M
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:215 STARING LN
Mailing Address - Street 2:
Mailing Address - City:BATON ROUGE
Mailing Address - State:LA
Mailing Address - Zip Code:70810-4064
Mailing Address - Country:US
Mailing Address - Phone:225-444-5764
Mailing Address - Fax:225-444-5946
Practice Address - Street 1:302 LAFAYETTE ST STE B
Practice Address - Street 2:
Practice Address - City:YOUNGSVILLE
Practice Address - State:LA
Practice Address - Zip Code:70592-5479
Practice Address - Country:US
Practice Address - Phone:337-856-1717
Practice Address - Fax:337-856-1818
Is Sole Proprietor?:No
Enumeration Date:2019-09-05
Last Update Date:2022-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA104552251S0007X, 2251X0800X, 225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
No2251S0007XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistSports
No2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic