Provider Demographics
NPI:1962777011
Name:PARKER, RAQUEL MONIQUE (DC)
Entity type:Individual
Prefix:
First Name:RAQUEL
Middle Name:MONIQUE
Last Name:PARKER
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12320 HIGHWAY 44 STE 2A
Mailing Address - Street 2:
Mailing Address - City:GONZALES
Mailing Address - State:LA
Mailing Address - Zip Code:70737-2202
Mailing Address - Country:US
Mailing Address - Phone:225-644-8671
Mailing Address - Fax:225-644-6427
Practice Address - Street 1:12320 HIGHWAY 44 STE 2A
Practice Address - Street 2:
Practice Address - City:GONZALES
Practice Address - State:LA
Practice Address - Zip Code:70737-2202
Practice Address - Country:US
Practice Address - Phone:225-644-8671
Practice Address - Fax:225-644-6427
Is Sole Proprietor?:No
Enumeration Date:2012-03-21
Last Update Date:2012-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA1621111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor