Provider Demographics
NPI:1235397894
Name:SPARKS, CHRISTY LADONNA (PT)
Entity Type:Individual
Prefix:
First Name:CHRISTY
Middle Name:LADONNA
Last Name:SPARKS
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:CHRISTY
Other - Middle Name:LADONNA
Other - Last Name:NAPIER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PT
Mailing Address - Street 1:141 PICARDY CT
Mailing Address - Street 2:
Mailing Address - City:KERNERSVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:27284-6529
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:141 PICARDY CT
Practice Address - Street 2:
Practice Address - City:KERNERSVILLE
Practice Address - State:NC
Practice Address - Zip Code:27284-6529
Practice Address - Country:US
Practice Address - Phone:336-692-7592
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-05-29
Last Update Date:2008-05-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC9768225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist