Individual
MELISSA SPARKS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1201 BROAD ROCK BLVD, RICHMOND, VA 23224-4915
(804) 675-5000
Mailing address
1428 RED CREEK RD, PIKEVILLE, KY 41501-6737
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
1106955
KY
Other
Enumeration date
11/07/2013
Last updated
11/07/2013
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