Provider Demographics
NPI:1134595283
Name:PARKER, CHAD
Entity type:Individual
Prefix:
First Name:CHAD
Middle Name:
Last Name:PARKER
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17210 LANCASTER HWY
Mailing Address - Street 2:STE 401
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28277-2024
Mailing Address - Country:US
Mailing Address - Phone:828-262-1117
Mailing Address - Fax:
Practice Address - Street 1:206 SOUTHGATE DR
Practice Address - Street 2:STE 21C
Practice Address - City:BOONE
Practice Address - State:NC
Practice Address - Zip Code:28607-6250
Practice Address - Country:US
Practice Address - Phone:828-262-1117
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-08-12
Last Update Date:2015-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
1447237700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument Specialist