Individual
MRS. SAMANTHA SPARKS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
1100 SOUTHFIELD DR, PLAINFIELD, IN 46168-4498
(317) 838-3434
Mailing address
5632 BEALE ST, PLAINFIELD, IN 46168-0106
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
06004996A
IN
Other
Enumeration date
09/11/2017
Last updated
03/17/2018
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