Provider Demographics
NPI:1083944466
Name:PARRISH, JACOB M (DC)
Entity Type:Individual
Prefix:
First Name:JACOB
Middle Name:M
Last Name:PARRISH
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:217 FOX RD
Mailing Address - Street 2:
Mailing Address - City:KNOXVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37922-3381
Mailing Address - Country:US
Mailing Address - Phone:865-357-2600
Mailing Address - Fax:865-357-2611
Practice Address - Street 1:217 FOX RD
Practice Address - Street 2:
Practice Address - City:KNOXVILLE
Practice Address - State:TN
Practice Address - Zip Code:37922-3381
Practice Address - Country:US
Practice Address - Phone:865-357-2600
Practice Address - Fax:865-357-2611
Is Sole Proprietor?:No
Enumeration Date:2010-01-06
Last Update Date:2023-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN2369111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
11/14/1979OtherBIRTHDAY
TN2369OtherLICENSE NUMBER