Individual
NICOLE MARIE SPARE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.O.
Contact information
Practice address
900 WALNUT ST, 2ND FLOOR, PHILADELPHIA, PA 19107-5509
(215) 955-2243
(215) 955-2060
Mailing address
900 WALNUT ST, 2ND FLOOR, PHILADELPHIA, PA 19107-5509
(215) 955-2243
(215) 955-2060
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
OS016754
PA
2084N0400X
Neurology Physician
Primary
OS016754
PA
Other
Enumeration date
05/18/2010
Last updated
08/04/2015
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