Provider Demographics
NPI:1841327194
Name:SPARLING, PAUL BRYAN (MED, ATC)
Entity type:Individual
Prefix:MR
First Name:PAUL
Middle Name:BRYAN
Last Name:SPARLING
Suffix:
Gender:M
Credentials:MED, ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1568 JOLEE DR
Mailing Address - Street 2:
Mailing Address - City:HEBRON
Mailing Address - State:KY
Mailing Address - Zip Code:41048-9514
Mailing Address - Country:US
Mailing Address - Phone:513-455-8472
Mailing Address - Fax:
Practice Address - Street 1:1 PAUL BROWN STADIUM
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45202-3418
Practice Address - Country:US
Practice Address - Phone:513-455-8472
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-02-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH0005132255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer