Individual
MR. KING ANTHONY SPARKS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PHLEBOTOMY TECHNICIA
Contact information
Practice address
1254 N WILMINGTON BLVD, WILMINGTON, CA 90744-2402
(213) 926-7970
Mailing address
PO BOX 60526, LOS ANGELES, CA 90060-0526
(213) 926-7970
Taxonomy
Speciality
Code
Description
License number
State
171W00000X
Contractor
Primary
CPT3277799
CA
Other
Enumeration date
06/12/2009
Last updated
06/19/2009
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