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General NPI Number Information
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NPI Number | 1639074941
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Entity Type | Organization
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Legal Business Name | FEED YOUR SPARK LLC
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Dates
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Enumeration Date | 10/08/2026
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Last Update Date | 10/08/2026
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Provider Practice Location Address
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Address Line | 3623 SOUTH AVE
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City | SPRINGFIELD
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State | MO
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Zip | 65807-5220
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Country | US
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Telephone | 417-319-4281
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Fax |
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Provider Business Mailing Address
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Address Line | 3623 SOUTH AVE
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City | SPRINGFIELD
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State | MO
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Zip | 65807-5220
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Country | US
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Telephone | 417-365-1998
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | MRS. LINDSAY MEGAN SPARKS
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Credential | RDN, LD
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Telephone | 417-365-1998
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 133V00000X
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Taxonomy Name | Registered Dietitian
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License Number |
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License Number State | NULL
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