Provider Demographics
NPI:1841526191
Name:PARKER, ERIN DEVINE (MT)
Entity type:Individual
Prefix:MRS
First Name:ERIN
Middle Name:DEVINE
Last Name:PARKER
Suffix:
Gender:F
Credentials:MT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5009 EXCELSIOR BLVD
Mailing Address - Street 2:SUITE #152
Mailing Address - City:ST LOUIS PARK
Mailing Address - State:MN
Mailing Address - Zip Code:55416-3041
Mailing Address - Country:US
Mailing Address - Phone:612-599-8768
Mailing Address - Fax:763-535-8511
Practice Address - Street 1:5009 EXCELSIOR BLVD
Practice Address - Street 2:SUITE #152
Practice Address - City:ST LOUIS PARK
Practice Address - State:MN
Practice Address - Zip Code:55416-3041
Practice Address - Country:US
Practice Address - Phone:612-599-8768
Practice Address - Fax:763-535-8511
Is Sole Proprietor?:Yes
Enumeration Date:2009-10-21
Last Update Date:2009-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist