Individual
MISS JENNA L SPARKS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
9191 W THUNDERBIRD RD STE 108, PEORIA, AZ 85381-4270
(623) 974-3511
(623) 444-9741
Mailing address
9191 W THUNDERBIRD RD STE 108, PEORIA, AZ 85381-4270
(623) 974-3511
(623) 444-9741
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
MT-08278
AZ
Other
Enumeration date
04/15/2010
Last updated
04/15/2010
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