| NPI | 1306269006 |
|---|---|
| Doing Business As | SPARKS CLINIC INTERNAL MEDICINE |
| Entity Type | Organization |
| Authorized Contact | STACY LUCIUS President, Hmpn 239-552-3575 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine |
| Enumeration Date | 2014-01-31 |
| Last Update Date | 2014-01-31 |