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1740722974
JONATHAN SPARKS
LARAMIE, WY
NPI
1740722974
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
172V00000X Community Health Worker
Enumeration Date
2016-11-04
Last Update Date
2016-11-04
Business Address
-- JONATHAN SPARKS
4989 N 3RD ST
LARAMIE, WY 82072-9548
Phone number: 307-721-1515
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Mailing Address
-- JONATHAN SPARKS
4989 N 3RD ST
LARAMIE, WY 82072-9548
Phone number: 307-721-1515
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