Individual
ALICIA E SPARKS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
788 SHREWSBURY AVE, TINTON FALLS, NJ 07724-3080
(732) 758-1800
Mailing address
788 SHREWSBURY AVE, TINTON FALLS, NJ 07724-3080
Taxonomy
Speciality
Code
Description
License number
State
171W00000X
Contractor
Primary
—
—
Other
Enumeration date
10/04/2011
Last updated
10/04/2011
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