Provider Demographics
NPI:1639342413
Name:SPARKS-BECKETT, SHANA D (DC)
Entity Type:Individual
Prefix:DR
First Name:SHANA
Middle Name:D
Last Name:SPARKS-BECKETT
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2303 DENHAM WAY
Mailing Address - Street 2:
Mailing Address - City:POWELL
Mailing Address - State:TN
Mailing Address - Zip Code:37849-5575
Mailing Address - Country:US
Mailing Address - Phone:865-441-5370
Mailing Address - Fax:
Practice Address - Street 1:7217 CLINTON HWY
Practice Address - Street 2:SUITE D
Practice Address - City:POWELL
Practice Address - State:TN
Practice Address - Zip Code:37849-5221
Practice Address - Country:US
Practice Address - Phone:865-333-0999
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-04-11
Last Update Date:2017-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNDC0000002235111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor