Individual
SUMMER SPARKS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MEDICAL STUDENT
Contact information
Practice address
900 HOSPITAL DR, MADISONVILLE, KY 42431-1644
(270) 825-5100
Mailing address
3721 BARDSTOWN RD APT 309, LOUISVILLE, KY 40218-2261
(270) 820-6887
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
KY
Other
Enumeration date
04/05/2023
Last updated
04/05/2023
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