| Spark | |
|
903 S 9th Street Laramie WY 82070 | |
| (307) 399-2880 | |
| Not Available |
| Full Name | Spark |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 903 S 9th Street, Laramie, Wyoming |
| Authorized Official Name and Position | Gina Sigel (OWNER) |
| Authorized Official Contact | 3073992880 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Spark 903 S 9th Street Laramie WY 82070 Ph: (307) 399-2880 | Spark 903 S 9th Street Laramie WY 82070 Ph: (307) 399-2880 |
| NPI Number | 1528429917 |
|---|---|
| Provider Enumeration Date | 03/11/2016 |
| Last Update Date | 03/11/2016 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1528429917 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | LPC-1074 (Wyoming) | Primary |
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