Provider Demographics
NPI:1447980404
Name:PARKER, PAIGE PHELAN (DC)
Entity type:Individual
Prefix:
First Name:PAIGE
Middle Name:PHELAN
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 1:7209 CHAD COLLEY BLVD STE A
Mailing Address - Street 2:
Mailing Address - City:BARLING
Mailing Address - State:AR
Mailing Address - Zip Code:72923-3103
Mailing Address - Country:US
Mailing Address - Phone:479-719-5877
Mailing Address - Fax:
Practice Address - Street 1:7209 CHAD COLLEY BLVD STE A
Practice Address - Street 2:
Practice Address - City:BARLING
Practice Address - State:AR
Practice Address - Zip Code:72923-3103
Practice Address - Country:US
Practice Address - Phone:479-719-5877
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-06-13
Last Update Date:2022-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR16329111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor