Provider Demographics
NPI:1982325312
Name:PARSONS, SAMANTHA (DC)
Entity type:Individual
Prefix:
First Name:SAMANTHA
Middle Name:
Last Name:PARSONS
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 1:107 COUNTY ROAD 3283
Mailing Address - Street 2:
Mailing Address - City:SALEM
Mailing Address - State:MO
Mailing Address - Zip Code:65560-8296
Mailing Address - Country:US
Mailing Address - Phone:573-247-4664
Mailing Address - Fax:
Practice Address - Street 1:504 E SCENIC RIVERS BLVD STE C
Practice Address - Street 2:
Practice Address - City:SALEM
Practice Address - State:MO
Practice Address - Zip Code:65560-1820
Practice Address - Country:US
Practice Address - Phone:573-247-4664
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-09-05
Last Update Date:2022-11-29
Deactivation Date:2022-09-06
Deactivation Code:
Reactivation Date:2022-11-29
Provider Licenses
StateLicense IDTaxonomies
MO2022035194111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor