NICHOLAS ANDREW SPARKS

COBURG, OR
NPI1659918621
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy101YA0400X Counselor Addiction (Substance Use Disorder)
(Licence: OR  T-19-372)
Enumeration Date2019-12-09
Last Update Date2019-12-09
Business Address
MR. NICHOLAS ANDREW SPARKS
91150COBURG INDUSTRIAL WAY
COBURG, OR 97408
Phone number: 541-687-1110
Mailing Address
MR. NICHOLAS ANDREW SPARKS
91150 COBURG INDUSTRIAL WAY
COBURG, OR 97408
Phone number: 541-687-1110
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