Doctor Name: | MR. KEITH LEROY SPARKS |
NPI Number: | 1114098860 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | D.C. |
License Number: | DC23991 |
Business Practice Address: | 1107 Kern St Suite #7 Taft, CA - 932684604 |
Business Phone Number: | 6617652225 |
Business Fax Number: | 6617651421 |
Mailing Address: | 1107 Kern St, Suite #7 TAFT |
State: | CA |
Postal Code: | 932684604 |
Phone Number: | 6617652225 |
Fax Number: | 6617651421 |
NPI Enumeration Date: | 11/13/2006 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 111N00000X |
License Number: | DC23991 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | CA |
Taxonomy Type: | Chiropractic Providers |
Taxonomy Classification: | Chiropractor |
Taxonomy Specialization: | |
Taxonomy Definition: | A provider qualified by a Doctor of Chiropractic (D.C.), licensed by the State and who practices chiropractic medicine -that discipline within the healing arts which deals with the nervous system and its relationship to the spinal column and its interrelationship with other body systems. |