| NPI | 1376246884 |
|---|---|
| Doing Business As | SPARK MED SPA |
| Entity Type | Organization |
| Authorized Contact | ROBBIE J GARRETT Co Owner/Director 208-251-2660 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 261QH0100X Clinic/Center, Health Services |
| Enumeration Date | 2023-03-23 |
| Last Update Date | 2025-05-28 |