Individual
MELISSA R. SPARKS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
14 CAREFREE LN, PUEBLO, CO 81001-1712
(719) 696-9685
Mailing address
14 CAREFREE LN, PUEBLO, CO 81001-1712
(719) 696-9685
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
—
—
Other
Enumeration date
06/07/2013
Last updated
06/07/2013
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