| Sparkfit Community Inc | |
|
1202 Main St Ste 204 Little Rock AR 72202-5057 | |
| (501) 428-3217 | |
| Not Available |
| Full Name | Sparkfit Community Inc |
|---|---|
| Speciality | Counselor - Professional |
| Location | 1202 Main St Ste 204, Little Rock, Arkansas |
| Authorized Official Name and Position | Glenn Mccracken (OWNER) |
| Authorized Official Contact | 5014283217 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Sparkfit Community Inc 1324b Main St Little Rock AR 72202-5034 Ph: (501) 400-8682 | Sparkfit Community Inc 1202 Main St Ste 204 Little Rock AR 72202-5057 Ph: (501) 428-3217 |
| NPI Number | 1417511387 |
|---|---|
| Provider Enumeration Date | 04/26/2019 |
| Last Update Date | 08/05/2024 |
| Certification Date | 08/05/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1417511387 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YP2500X | Counselor - Professional | (* (Not Available)) | Primary |
| 225100000X | Physical Therapist | (* (Not Available)) | Secondary |
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