Individual
MISS ALIVIA BROOKE SPARKS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
444 ONE ELEVEN PL, COOKEVILLE, TN 38506-4358
(931) 525-6655
Mailing address
725 CINDY DR, COOKEVILLE, TN 38506-9737
(931) 854-7582
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
6626
TN
Other
Enumeration date
08/24/2021
Last updated
08/24/2021
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