Individual
COLIN PETER SPARKS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LMT
Contact information
Practice address
8202 EXCELSIOR DR, MADISON, WI 53717-1906
(608) 831-1766
(608) 831-1562
Mailing address
3637 ALPINE RD, MADISON, WI 53704-2201
(608) 335-6047
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
14944-146
WI
Other
Enumeration date
11/01/2019
Last updated
11/01/2019
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