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Carson Parks
NPI 1124523782 · on the registry since 2018
Practice
- Address
- 2225 Pocatello Creek Rd Apt A
Pocatello, ID 83201 - Phone
- (530) 209-6873
Registry record
- Primary taxonomy
- 390200000X
390200000X
- Also registered as
- 2255A2300X
- Licence states on file
- ID
From the registry's licence fields, which are often incomplete.
- Sex
- Male
- Record last updated
- 2018-03-27
Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in Idaho