Provider Demographics
NPI:1720390479
Name:PARKS, CARYL B (MT(ASCP))
Entity Type:Individual
Prefix:MS
First Name:CARYL
Middle Name:B
Last Name:PARKS
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Gender:F
Credentials:MT(ASCP)
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Mailing Address - Street 1:260 GRANDVIEW DR
Mailing Address - Street 2:INN AT LANDER BEST WESTERN ROOM 609
Mailing Address - City:LANDER
Mailing Address - State:WY
Mailing Address - Zip Code:82520-2928
Mailing Address - Country:US
Mailing Address - Phone:704-516-4409
Mailing Address - Fax:307-332-7514
Practice Address - Street 1:29 BLACK COAL RD
Practice Address - Street 2:LABORATORY
Practice Address - City:FORT WASHAKIE
Practice Address - State:WY
Practice Address - Zip Code:82514-0128
Practice Address - Country:US
Practice Address - Phone:307-332-7672
Practice Address - Fax:307-332-7514
Is Sole Proprietor?:Yes
Enumeration Date:2010-07-10
Last Update Date:2010-07-10
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246QM0706XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, PathologyMedical Technologist