Individual
IAN SPARKS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA
Contact information
Practice address
18697 BAGLEY RD, MIDDLEBURG HEIGHTS, OH 44130-3417
(440) 816-8000
Mailing address
PO BOX 638478, CINCINNATI, OH 45263-8478
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
50-005023RX
OH
Other
Enumeration date
06/12/2017
Last updated
06/12/2017
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