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Individual

VICKI LYNN SPARKS

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
10000 W 75TH ST, SUITE 250, MERRIAM, KS 66204-2209
(913) 894-1910
(913) 894-1174
Mailing address
10000 W 75TH ST, SUITE 250, MERRIAM, KS 66204-2209
(913) 894-1910
(913) 894-1174

Taxonomy

Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
001061
MO
174400000X
Specialist
17-00525
KS

Other

Enumeration date
12/12/2006
Last updated
02/23/2012
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