Individual
SEAN PAUL SPARE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
IDC
Contact information
Practice address
2606 LOWER GAINESVILLE RD, STENNIS SPACE CENTER, MS 39529-0001
(228) 813-4050
Mailing address
2606 LOWER GAINESVILLE ROAD, STENNIS SPACE CENTER, MS 39529-0001
(228) 813-4050
Taxonomy
Speciality
Code
Description
License number
State
1710I1002X
Independent Duty Corpsman
Primary
—
—
Other
Enumeration date
09/23/2022
Last updated
09/23/2022
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