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NPI Code Detail

MEDICARE: MARCY E SPARKS DPT

MEDICARE: MARCY E SPARKS DPT
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1225100000XPhysical TherapistPT025680PA

General Provider Information

NPI Number : 1417491101
Entity Type Code : Individual
Provider Name (Legal Business Name) : MARCY E SPARKS DPT
Provider Business Mailing Address
First Line : 310 PASADENA DR S
Second Line :
City : PITTSBURGH
State : PA
Zip : 15215-1916
Country : US
Telephone Number : 412-770-8842
Fax Number :
Provider Business Practice Location Address
First Line : 507 PITTSBURGH ST
Second Line :
City : SPRINGDALE
State : PA
Zip : 15144-1409
Country : US
Telephone Number : 724-275-7827
Fax Number : 724-275-7749
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/14/2016
Last Update Date : 12/14/2016

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Directions to “ MARCY E SPARKS DPT” Practice Location

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