Provider Demographics
NPI:1891936217
Name:PARKER, CARLA O (CFTS)
Entity Type:Individual
Prefix:
First Name:CARLA
Middle Name:O
Last Name:PARKER
Suffix:
Gender:F
Credentials:CFTS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:50 E 66TH ST
Mailing Address - Street 2:
Mailing Address - City:SAVANNAH
Mailing Address - State:GA
Mailing Address - Zip Code:31405-5211
Mailing Address - Country:US
Mailing Address - Phone:912-667-1456
Mailing Address - Fax:912-354-2872
Practice Address - Street 1:50 E 66TH ST
Practice Address - Street 2:
Practice Address - City:SAVANNAH
Practice Address - State:GA
Practice Address - Zip Code:31405-5211
Practice Address - Country:US
Practice Address - Phone:912-667-1456
Practice Address - Fax:912-354-2872
Is Sole Proprietor?:Yes
Enumeration Date:2009-03-14
Last Update Date:2013-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GACFTS0624247200000X
GA332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes247200000XTechnologists, Technicians & Other Technical Service ProvidersTechnician, Other
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA0624OtherCERTIFIED THERAPUTIC SHOE FITTER (CFTS)