Individual
THERESA SPARKES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
L.AC
Contact information
Practice address
87 STATE RT 17 N, MAYWOOD, NJ 07607-1017
(973) 798-8457
Mailing address
18 SLATE HILL TER, GREENWOOD LAKE, NY 10925-4010
Taxonomy
Speciality
Code
Description
License number
State
171100000X
Acupuncturist
Primary
25MZ00117600
NJ
Other
Enumeration date
03/07/2016
Last updated
03/07/2016
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