Provider Demographics
NPI:1417562109
Name:PARSONS, RYAN CALEB
Entity Type:Individual
Prefix:
First Name:RYAN
Middle Name:CALEB
Last Name:PARSONS
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:132 WALKER LANE
Mailing Address - Street 2:
Mailing Address - City:EAST LYNN
Mailing Address - State:WV
Mailing Address - Zip Code:25512
Mailing Address - Country:US
Mailing Address - Phone:304-849-3452
Mailing Address - Fax:
Practice Address - Street 1:132 WALKER LANE
Practice Address - Street 2:
Practice Address - City:EAST LYNN
Practice Address - State:WV
Practice Address - Zip Code:25512
Practice Address - Country:US
Practice Address - Phone:304-849-3452
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-09-10
Last Update Date:2021-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant