Provider Demographics
NPI:1629512785
Name:PARHAM, JONATHAN (DC)
Entity Type:Individual
Prefix:DR
First Name:JONATHAN
Middle Name:
Last Name:PARHAM
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 1:1195 SELMI DR
Mailing Address - Street 2:APT C307
Mailing Address - City:RENO
Mailing Address - State:NV
Mailing Address - Zip Code:89512-7719
Mailing Address - Country:US
Mailing Address - Phone:408-410-2894
Mailing Address - Fax:
Practice Address - Street 1:525 E MOANA LN
Practice Address - Street 2:
Practice Address - City:RENO
Practice Address - State:NV
Practice Address - Zip Code:89502-4671
Practice Address - Country:US
Practice Address - Phone:775-827-1200
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-12-08
Last Update Date:2016-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NVB01628111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor