Individual
DEBRA SPARKS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
222 BRENT DR W APT M, SPRINGFIELD, OH 45505-4833
(937) 207-0996
Mailing address
222 BRENT DR W APT M, SPRINGFIELD, OH 45505-4833
(937) 207-0996
Taxonomy
Speciality
Code
Description
License number
State
172A00000X
Driver
Primary
RL994726
OH
Other
Enumeration date
08/22/2025
Last updated
08/22/2025
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