Individual
JAY D SPARKS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PT, DPT
Contact information
Practice address
227500 RIB MOUNTAIN DR STE 220, WAUSAU, WI 54401-5052
(800) 974-4378
(630) 515-1536
Mailing address
24014 W RENWICK RD UNIT 206, PLAINFIELD, IL 60544-8711
(800) 974-4378
(630) 515-1536
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
13000-24
WI
Other
Enumeration date
08/13/2015
Last updated
10/18/2022
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