Most Relevant Information
Provider Data
| NPI Number: | 1003569864 |
| Provider Name: | JESSICA SPARKS |
| Entity Type: | Individual |
| Taxonomy Code: | 225100000X |
| Specialty: | Physical Therapist |
| License Number: |
Most Important Dates
| Enumeration Date: | 02/01/2022 |
| Last Updated: | 02/01/2022 |
Provider Practice Location
119 E SANDERS LN
MOUNT WASHINGTON
KY
400477557
Practice Location Phone/Fax
| Phone: | 5022513821 |
| Fax: |
Provider Mailing Location
1255 ASH ST
LOUISVILLE
KY
402171561
Provider Mailing Phone/Fax
| Phone: | 8124307801 |
| Fax: |