| Spark LLC | |
|
323 Walnut St Ste A Lawrenceburg IN 47025-1841 | |
| (419) 233-3061 | |
| Not Available |
| Full Name | Spark LLC |
|---|---|
| Speciality | Clinic/center - Community Health |
| Location | 323 Walnut St Ste A, Lawrenceburg, Indiana |
| Authorized Official Name and Position | Kara J Goode (SOCIAL WORKER/OWNER) |
| Authorized Official Contact | 4192333061 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Spark LLC 323 Walnut St Ste A Lawrenceburg IN 47025-1841 Ph: (419) 233-3061 | Spark LLC 323 Walnut St Ste A Lawrenceburg IN 47025-1841 Ph: (419) 233-3061 |
| NPI Number | 1285402479 |
|---|---|
| Provider Enumeration Date | 12/18/2023 |
| Last Update Date | 12/18/2023 |
| Certification Date | 12/17/2023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1285402479 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QC1500X | Clinic/center - Community Health | () | Primary |
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