Organization
THE SPARKS GROUP, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. BEVERLY TWITTY M.S. (DIRECTOR)
(301) 219-8190
Entity
Organization
Contact information
Practice address
3547 CARRIAGE WALK LN, LAUREL, MD 20724-2052
(301) 219-8190
Mailing address
4119 ELLIS ST, CAPITOL HEIGHTS, MD 20743-5756
(301) 219-8190
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
1-062876
MD
Other
Enumeration date
06/26/2012
Last updated
06/26/2012
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