Individual
MRS. IRINA VITA SPARKS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
200 HIGH PARK AVE, GOSHEN, IN 46526-4810
(574) 364-2888
Mailing address
200 HIGH PARK AVE, GOSHEN, IN 46526-4810
Taxonomy
Speciality
Code
Description
License number
State
2085R0001X
Radiation Oncology Physician
Primary
01080898A
IN
Other
Enumeration date
04/03/2013
Last updated
01/20/2021
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