Individual
MISS ASHLEY RENEE SPARKS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
8158 PEA RIDGE RD, BROOKVILLE, IN 47012
(765) 265-5813
Mailing address
8158 PEA RIDGE RD, BROOKVILLE, IN 47012-7712
(765) 265-5813
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
—
—
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
03/28/2016
Last updated
03/28/2016
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