MEDICARE: PRESTON SPARKS

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
1	225100000X	Physical Therapist	PT016725	GA

General Provider Information

NPI Number	:	1588346787
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	PRESTON SPARKS

Provider Business Mailing Address
First Line	:	105 FIELDFARE DR
Second Line	:
City	:	KATHLEEN
State	:	GA
Zip	:	31047-2532
Country	:	US
Telephone Number	:	478-952-3782
Fax Number	:

Provider Business Practice Location Address
First Line	:	2669 OSBORNE RD NE
Second Line	:
City	:	BROOKHAVEN
State	:	GA
Zip	:	30319-8400
Country	:	US
Telephone Number	:	404-477-7777
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/07/2023
Last Update Date	:	08/07/2023

Similar Medicare Providers

1801834163 — SHELLEY SMITH DICECCO MSPT
Practice Location Address:

2669 OSBORNE RD NE
BROOKHAVEN, GA
30319-8400

Practice Phone: 404-477-7777
Practice Fax: 404-477-7000

1427797232 — DR. ERICA CAREY DEKLE PT, DPT
Practice Location Address:

2669 OSBORNE RD NE
BROOKHAVEN, GA
30319-8400

Practice Phone: 404-477-7777
Practice Fax:

1629364237 — THERESA CORREA PT
Practice Location Address:

2669 OSBORNE RD NE
ATLANTA, GA
30319-8400

Practice Phone: 404-477-7777
Practice Fax: 404-477-7000

1215990882 — MS. CARRIE ANN BARTELME MS, OTR-L
Practice Location Address:

4062 PEACHTREE RD NE STE A-123
BROOKHAVEN, GA
30319-3021

Practice Phone: 404-409-7099
Practice Fax:

1982649422 — DR. NIDHI JAIN MD, MPH
Practice Location Address:

1376 BROOKHAVEN VILLAGE CIR NE
ATLANTA, GA
30319-4095

Practice Phone: 404-848-0261
Practice Fax:

1184660367 — MAREK MA MD
Practice Location Address:

1820 DRESDEN DR NE
BROOKHAVEN, GA
30319-3632

Practice Phone: 215-301-3948
Practice Fax:

Directions to “ PRESTON SPARKS ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.