Provider Demographics
NPI:1831969187
Name:PARRISH, PAUL ALAN (DC)
Entity type:Individual
Prefix:DR
First Name:PAUL
Middle Name:ALAN
Last Name:PARRISH
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 1:594 BRIDGEBEND RD
Mailing Address - Street 2:
Mailing Address - City:MANCHESTER
Mailing Address - State:MO
Mailing Address - Zip Code:63021-6704
Mailing Address - Country:US
Mailing Address - Phone:484-366-6324
Mailing Address - Fax:
Practice Address - Street 1:300 OZARK TRAIL DR STE 105
Practice Address - Street 2:
Practice Address - City:ELLISVILLE
Practice Address - State:MO
Practice Address - Zip Code:63011-2156
Practice Address - Country:US
Practice Address - Phone:636-207-6600
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-01-08
Last Update Date:2024-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2024000511111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor