Individual
DANIEL PAUL SPARKS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
39 BROAD STREET EXT, GROTON, CT 06340-3746
(623) 297-7438
Mailing address
39 BROAD STREET EXT, GROTON, CT 06340-3746
Taxonomy
Speciality
Code
Description
License number
State
1710I1002X
Independent Duty Corpsman
Primary
—
—
Other
Enumeration date
01/03/2024
Last updated
01/03/2024
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