Provider Demographics
NPI:1871599803
Name:PARSONS, MIKELL SUZANNE (DC)
Entity type:Individual
Prefix:DR
First Name:MIKELL
Middle Name:SUZANNE
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 1:6103 N 1ST ST
Mailing Address - Street 2:STE 104
Mailing Address - City:FRESNO
Mailing Address - State:CA
Mailing Address - Zip Code:93710-5461
Mailing Address - Country:US
Mailing Address - Phone:559-447-1404
Mailing Address - Fax:559-447-1774
Practice Address - Street 1:6103 N 1ST ST
Practice Address - Street 2:STE 104
Practice Address - City:FRESNO
Practice Address - State:CA
Practice Address - Zip Code:93710-5461
Practice Address - Country:US
Practice Address - Phone:559-447-1404
Practice Address - Fax:559-447-1774
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-06-23
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC 22430111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAU42231Medicare UPIN
CADC0224300Medicare ID - Type UnspecifiedMEDICARE PROVIDER ID