Individual
MRS. KATHLEEN MALONE SPARKS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
ATC, LAT
Contact information
Practice address
714 N SENATE AVE STE 200, INDIANAPOLIS, IN 46202-3297
(317) 688-5384
Mailing address
714 N SENATE AVE STE 200, INDIANAPOLIS, IN 46202-3297
(317) 688-5384
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
36000129A
IN
Other
Enumeration date
09/26/2013
Last updated
04/16/2020
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