Individual
MISS VICTORIA SPARKES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
700 MAIN ST, WRAY, CO 80758-1739
(970) 542-3256
Mailing address
700 MAIN ST, WRAY, CO 80758-1739
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
OT-2984
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
MAP6403
BLUE CROSS BLUE SHIELD
CO
Enumeration date
08/02/2010
Last updated
08/02/2010
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