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Contact Information

JACOB PARKS
11335 SUNSET HILLS RD
RESTON, VA20190-5205
 Phone: 703-348-7857
 Fax: 703-444-4308
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Counselor

101Y00000X
 

Clinical Exercise Physiologist

224Y00000X
 

Nutritionist

133N00000X
Indicates primary specialty

NPI Profile & details for JACOB PARKS · (Male)

NPI Number 1760751861
Status Active
Credentials
Entity Individual
Enumeration date 12/19/2011
Last updated 12/19/2011 - About 14 years ago
Sole proprietor 1 No
Identifiers Not Available
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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