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General NPI Number Information
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NPI Number | 1093983322
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Entity Type | Organization
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Legal Business Name | PATRICIA L. SPARKS, O.D., L.L.C.
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Dates
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Enumeration Date | 02/20/2008
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Last Update Date | 02/20/2008
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Provider Practice Location Address
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Address Line | 2291 N 2ND ST
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City | MILLVILLE
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State | NJ
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Zip | 08332-1305
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Country | US
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Telephone | 856-825-8964
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Fax | 856-825-3988
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Provider Business Mailing Address
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Address Line | 2291 N 2ND ST
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City | MILLVILLE
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State | NJ
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Zip | 08332-1305
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Country | US
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Telephone | 856-825-8964
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Fax | 856-825-3988
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Authorized Official
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Title or Position | OPTOMETRIST/ OWNER
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Name | DR. PATRICIA LYNN SPARKS
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Credential | O.D.
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Telephone | 856-825-8964
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number |
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License Number State |
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