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Individual

MR. LARRY SPARKS

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man

Contact information

Practice address
10476 131ST ST, LARGO, FL 33774-4734
(727) 593-5569
(727) 593-3140
Mailing address
10476 131ST ST, LARGO, FL 33774-4734
(727) 593-5569
(727) 593-3140

Taxonomy

Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
8317
FL

Other

Enumeration date
10/30/2013
Last updated
10/30/2013
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