Provider Demographics
NPI:1467791046
Name:PARKS, JANET LYNNE (PTA)
Entity Type:Individual
Prefix:
First Name:JANET
Middle Name:LYNNE
Last Name:PARKS
Suffix:
Gender:F
Credentials:PTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1519 STONINGTON DR
Mailing Address - Street 2:
Mailing Address - City:GLENSHAW
Mailing Address - State:PA
Mailing Address - Zip Code:15116-2529
Mailing Address - Country:US
Mailing Address - Phone:412-487-5037
Mailing Address - Fax:
Practice Address - Street 1:1519 STONINGTON DR
Practice Address - Street 2:
Practice Address - City:GLENSHAW
Practice Address - State:PA
Practice Address - Zip Code:15116-2529
Practice Address - Country:US
Practice Address - Phone:412-487-5037
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-02-03
Last Update Date:2013-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PATE1000861225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant