Individual
JAQUITA SPARKMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1045 WOODVILLE DR, JACKSON, MS 39212-3955
(601) 813-2655
Mailing address
1517 N HASKELL AVE, DALLAS, TX 75204-5161
(601) 813-2655
Taxonomy
Speciality
Code
Description
License number
State
247200000X
Other Technician
Primary
—
—
Other
Enumeration date
06/11/2016
Last updated
06/11/2016
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