Provider Demographics
NPI:1356629372
Name:PARKER WELLNESS, LLC
Entity Type:Organization
Organization Name:PARKER WELLNESS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/LICENSED MASSAGE THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:CHRISTINE
Authorized Official - Middle Name:
Authorized Official - Last Name:JACOBSEN
Authorized Official - Suffix:
Authorized Official - Credentials:LMT
Authorized Official - Phone:303-913-8686
Mailing Address - Street 1:19731 E PIKES PEAK CT
Mailing Address - Street 2:STE 201
Mailing Address - City:PARKER
Mailing Address - State:CO
Mailing Address - Zip Code:80138-7401
Mailing Address - Country:US
Mailing Address - Phone:303-913-8686
Mailing Address - Fax:
Practice Address - Street 1:19731 E PIKES PEAK CT
Practice Address - Street 2:STE 201
Practice Address - City:PARKER
Practice Address - State:CO
Practice Address - Zip Code:80138-7401
Practice Address - Country:US
Practice Address - Phone:303-913-8686
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-07-25
Last Update Date:2011-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0400XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation