Organization
SPARK REHAB SPECIALIST LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. BRIAN VERGARA CORNEJO PT,DPT (OWNER)
(361) 389-4285
Entity
Organization
Contact information
Practice address
6025 TAPESTRY DR, CORPUS CHRISTI, TX 78414-6334
(361) 389-4285
Mailing address
6025 TAPESTRY DR, CORPUS CHRISTI, TX 78414-6334
(361) 389-4285
Taxonomy
Speciality
Code
Description
License number
State
261QP2000X
Physical Therapy Clinic/Center
Primary
—
—
Other
Enumeration date
04/22/2019
Last updated
04/22/2019
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