Individual
JEFF SPARKS
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Contact information
Practice address
2000B S SPRINGFIELD AVE, BOLIVAR, MO 65613-9654
(417) 326-7455
(417) 326-7757
Mailing address
PO BOX 33, BOLIVAR, MO 65613-0033
(417) 326-7455
(417) 326-7757
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
005482
MO
Other
Enumeration date
02/28/2006
Last updated
07/09/2007
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