| NPI | 1578745923 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARGARET K SPARKS Owner/Sole Practioner 866-200-9874 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207N00000X Dermatology (Licence: KY 23102) |
| Enumeration Date | 2007-11-28 |
| Last Update Date | 2013-03-27 |