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Organization
SPARK THERAPIES LLC
Active
Organization
SPARK THERAPIES LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. JESSICA O'HARA (MEMBER/OWNER)
(603) 865-5064
Entity
Organization
Contact information
Practice address
151 ROUTE 10 N UNIT 2, GRANTHAM, NH 03753-3617
(603) 865-5064
Mailing address
10 BENNING ST STE 160-109, WEST LEBANON, NH 03784-3402
(603) 865-5064
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
—
—
225A00000X
Music Therapist
—
—
225X00000X
Occupational Therapist
—
—
235Z00000X
Speech-Language Pathologist
Primary
—
—
246ZA2600X
Medical Art Specialist/Technologist
—
—
Other
Enumeration date
08/29/2017
Last updated
08/29/2017
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