Margaret Marie Sparks, COTA/L

Individual provider Active NPI Skilled Nursing Facility · Palmyra, MO

NPI 1760670368 · NPPES record last updated Oct 9, 2007

Key facts

NPI
1760670368
Entity type
Individual (NPI type 1)
Primary specialty
Skilled Nursing Facility 314000000X
License
20000169350 (MO)
Practice address
104 N East St
Palmyra, MO 63461-1741
Phone
(816) 786-9372
NPI assigned
Oct 9, 2007
Sex
Female
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
20000169350MOMDSkilled Nursing Facility

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Skilled Nursing Facility 314000000X 20000169350 MO Yes

Addresses

Primary practice location

104 N East St
Palmyra, MO 63461-1741

Mailing address

104 N East St
Palmyra, MO 63461-1741
Phone (816) 786-9372

Other providers in Palmyra, MO

All providers in Palmyra, MO · Skilled Nursing Facility in Missouri

Sources for this page

Verify at the official NPI Registry.