Provider Demographics
NPI:1689852311
Name:PARKER, AMANDA TOLISE (LMT)
Entity Type:Individual
Prefix:
First Name:AMANDA
Middle Name:TOLISE
Last Name:PARKER
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:145 ARSENAL DR
Mailing Address - Street 2:
Mailing Address - City:FRANKLIN
Mailing Address - State:TN
Mailing Address - Zip Code:37064-2302
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2416 MUSIC VALLEY DR
Practice Address - Street 2:SUITE 119
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37214-1011
Practice Address - Country:US
Practice Address - Phone:615-294-5233
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-02-05
Last Update Date:2008-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN4743225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist