BRIAN WAYNE SPARKS

BOSSIER CITY, LA
NPI1689907362
Entity TypeIndividual
GenderMale
Sole Proprietor ?Yes
Primary Taxonomy363A00000X Physician Assistant
(Licence: LA  PA.200306)
Enumeration Date2009-09-11
Last Update Date2009-09-29
Business Address
Mr. BRIAN WAYNE SPARKS PA-C
407 GATOR CV
BOSSIER CITY, LA 71111-8219
Phone number: 318-208-2029
Mailing Address
Mr. BRIAN WAYNE SPARKS PA-C
407 GATOR CV
BOSSIER CITY, LA 71111-8219
Phone number: 318-208-2029
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