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1053824771
MARK ANTHONY SPARKS
LARAMIE, WY
NPI
1053824771
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
171M00000X Case Manager/Care Coordinator
Enumeration Date
2017-11-16
Last Update Date
2018-03-23
Business Address
MARK ANTHONY SPARKS
1263 N 15TH ST
LARAMIE, WY 82072-2343
Phone number: 307-745-8915
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Mailing Address
MARK ANTHONY SPARKS
510 W 29TH ST
CHEYENNE, WY 82001-2760
Phone number: 307-426-4728
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