Provider Demographics
NPI:1962853150
Name:PARMELE, JUSTIN (LMT)
Entity Type:Individual
Prefix:
First Name:JUSTIN
Middle Name:
Last Name:PARMELE
Suffix:
Gender:M
Credentials:LMT
Other - Prefix:
Other - First Name:JALEN
Other - Middle Name:
Other - Last Name:PARMELE
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:LMT
Mailing Address - Street 1:1313 W MESQUITE TREE LN
Mailing Address - Street 2:
Mailing Address - City:SAN TAN VALLEY
Mailing Address - State:AZ
Mailing Address - Zip Code:85143-3510
Mailing Address - Country:US
Mailing Address - Phone:989-615-4971
Mailing Address - Fax:
Practice Address - Street 1:2373 E BASELINE RD
Practice Address - Street 2:
Practice Address - City:GILBERT
Practice Address - State:AZ
Practice Address - Zip Code:85234-2477
Practice Address - Country:US
Practice Address - Phone:480-815-4333
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-06-28
Last Update Date:2022-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
174400000X
AZMT-22305225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist
No174400000XOther Service ProvidersSpecialist