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1174736540
SHAWN PATRICK SPARKS
BILOXI, MS
NPI
1174736540
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
2255A2300X Specialist/Technologist, Athletic Trainer
(Licence: MS AT0312)
Enumeration Date
2007-05-08
Last Update Date
2007-07-08
Business Address
Mr. SHAWN PATRICK SPARKS A.T.C.
15012 LEMOYNE BLVD
BILOXI, MS 39532-5205
Phone number: 228-396-1285
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Mailing Address
Mr. SHAWN PATRICK SPARKS A.T.C.
1633 S. 11TH ST.
OCEAN SPRINGS, MS 39564
Phone number: 228-875-5833
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