Provider Demographics
NPI:1831270057
Name:PARROTT, BLANE LELAND (DC)
Entity type:Individual
Prefix:DR
First Name:BLANE
Middle Name:LELAND
Last Name:PARROTT
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5849 ALMOND ST
Mailing Address - Street 2:
Mailing Address - City:PARADISE
Mailing Address - State:CA
Mailing Address - Zip Code:95969-4506
Mailing Address - Country:US
Mailing Address - Phone:530-877-9355
Mailing Address - Fax:530-877-0234
Practice Address - Street 1:5849 ALMOND ST
Practice Address - Street 2:
Practice Address - City:PARADISE
Practice Address - State:CA
Practice Address - Zip Code:95969-4506
Practice Address - Country:US
Practice Address - Phone:530-877-9355
Practice Address - Fax:530-877-0234
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC28416111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA87-0689496OtherTAX ID#
CA87-0689496OtherTAX ID#
CADC0284160Medicare ID - Type Unspecified