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Individual

MRS. RAINA ANN SPARKS

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
RD/LD

Contact information

Practice address
1127 S GEORGE NIGH EXPY, MCALESTER, OK 74501-7143
(918) 423-8440
Mailing address
1127 S GEORGE NIGH EXPY, MCALESTER, OK 74501-7143
(918) 423-8440

Taxonomy

Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
953572
OK

Other

Enumeration date
04/09/2009
Last updated
04/09/2009
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