Individual
SPARKLE PAYNE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
4160 S PECOS RD, SUITE 18, LAS VEGAS, NV 89121-5025
(702) 396-3464
Mailing address
1915 SIMMONS ST, APT 1091, LAS VEGAS, NV 89106-1666
Taxonomy
Speciality
Code
Description
License number
State
225400000X
Rehabilitation Practitioner
Primary
—
—
Other
Enumeration date
10/24/2016
Last updated
10/24/2016
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