Provider Demographics
NPI:1477118016
Name:PARKER, WILLIAM CHAD (MS ATC)
Entity Type:Individual
Prefix:
First Name:WILLIAM
Middle Name:CHAD
Last Name:PARKER
Suffix:
Gender:M
Credentials:MS ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4975 PARK RIDGE BLVD
Mailing Address - Street 2:
Mailing Address - City:BOYNTON BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33426-8336
Mailing Address - Country:US
Mailing Address - Phone:804-301-8857
Mailing Address - Fax:
Practice Address - Street 1:4975 PARK RIDGE BLVD
Practice Address - Street 2:
Practice Address - City:BOYNTON BEACH
Practice Address - State:FL
Practice Address - Zip Code:33426-8336
Practice Address - Country:US
Practice Address - Phone:804-301-8857
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-05-09
Last Update Date:2019-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL174H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174H00000XOther Service ProvidersHealth EducatorGroup - Single Specialty