Basic Information
| Provider Information | |||||||||
| NPI: | 1831134642 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | PARRY | ||||||||
| FirstName: | PHILLIP | ||||||||
| MiddleName: | BRADLEY | ||||||||
| NamePrefix: | MR. | ||||||||
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| Credential: | LAT, ATC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 3517 SW SPRING HILL DR | ||||||||
| Address2: | |||||||||
| City: | TOPEKA | ||||||||
| State: | KS | ||||||||
| PostalCode: | 666144585 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7854784393 | ||||||||
| FaxNumber: | 7853576589 | ||||||||
| Practice Location | |||||||||
| Address1: | 909 SW MULVANE ST | ||||||||
| Address2: | |||||||||
| City: | TOPEKA | ||||||||
| State: | KS | ||||||||
| PostalCode: | 666061677 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7853570301 | ||||||||
| FaxNumber: | 7853576589 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/17/2006 | ||||||||
| LastUpdateDate: | 07/08/2007 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | X | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 2255A2300X | 24-00022 | KS | Y | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Specialist/Technologist | Athletic Trainer |
No ID Information.