Provider Demographics
NPI:1598163792
Name:PARADA, ERIC D (DC)
Entity Type:Individual
Prefix:DR
First Name:ERIC
Middle Name:D
Last Name:PARADA
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 1:1269 BARCLAY CIRCLE
Mailing Address - Street 2:
Mailing Address - City:MARIETTA
Mailing Address - State:GA
Mailing Address - Zip Code:30060
Mailing Address - Country:US
Mailing Address - Phone:770-426-2600
Mailing Address - Fax:
Practice Address - Street 1:12465 OCEAN HWY
Practice Address - Street 2:
Practice Address - City:PAWLEYS ISLAND
Practice Address - State:SC
Practice Address - Zip Code:29585-7148
Practice Address - Country:US
Practice Address - Phone:843-979-2273
Practice Address - Fax:843-235-3427
Is Sole Proprietor?:No
Enumeration Date:2014-12-21
Last Update Date:2017-06-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC3938111N00000X
GA9898111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor