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General NPI Number Information
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NPI Number | 1497836852
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Entity Type | Individual
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Provider Name | LAURA SUE SPARKS D.C.
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Gender | Female
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Dates
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Enumeration Date | 10/18/2006
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Last Update Date | 07/09/2007
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Provider Practice Location Address
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Address Line | 365 E MAIN ST
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City | LANCASTER
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State | OH
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Zip | 43130-3845
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Country | US
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Telephone | 740-689-1175
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Fax |
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Provider Business Mailing Address
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Address Line | 6622 KING ARTHURS CT
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City | CARROLL
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State | OH
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Zip | 43112-9788
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Country | US
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Telephone | 740-756-7462
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | 2155
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License Number State | OH
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