| NPI | 1174627665 |
|---|---|
| Doing Business As | SPARKS PEDIATRIC CLINIC |
| Entity Type | Organization |
| Authorized Contact | REBECCA COX Cbo Support Manager 479-709-7057 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332B00000X Durable Medical Equipment & Medical Supplies |
| Enumeration Date | 2006-09-13 |
| Last Update Date | 2020-08-22 |