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Organization

SPARK THERAPIES LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MRS. JESSICA O'HARA (MEMBER/OWNER)
(603) 865-5064
Entity
Organization

Contact information

Practice address
151 ROUTE 10 N UNIT 2, GRANTHAM, NH 03753-3617
(603) 865-5064
Mailing address
10 BENNING ST STE 160-109, WEST LEBANON, NH 03784-3402
(603) 865-5064

Taxonomy

Speciality
Code
Description
License number
State
225100000X
Physical Therapist
225A00000X
Music Therapist
225X00000X
Occupational Therapist
235Z00000X
Speech-Language Pathologist
Primary
246ZA2600X
Medical Art Specialist/Technologist

Other

Enumeration date
08/29/2017
Last updated
08/29/2017
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