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Individual
MS. SUSAN M SPARKS
Active
Individual
MS. SUSAN M SPARKS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
01782
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0349674
—
MA
01
—
10048048
RAILROAD MEDICARE
MA
01
—
10078447
CDPHP
MA
01
—
435807
MVP
MA
01
—
SPY65360
BCBS OF MASSACHUSETTS
MA
Enumeration date
12/20/2005
Last updated
07/08/2007
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