Provider Demographics
NPI:1174764435
Name:SPARKS, KASEY AARON (PT, DPT)
Entity type:Individual
Prefix:
First Name:KASEY
Middle Name:AARON
Last Name:SPARKS
Suffix:
Gender:M
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6169 S BALSAM WAY
Mailing Address - Street 2:STE 110
Mailing Address - City:LITTLETON
Mailing Address - State:CO
Mailing Address - Zip Code:80123-3062
Mailing Address - Country:US
Mailing Address - Phone:303-948-1868
Mailing Address - Fax:303-948-1741
Practice Address - Street 1:6169 S BALSAM WAY
Practice Address - Street 2:STE 110
Practice Address - City:LITTLETON
Practice Address - State:CO
Practice Address - Zip Code:80123-3062
Practice Address - Country:US
Practice Address - Phone:303-948-1868
Practice Address - Fax:303-948-1741
Is Sole Proprietor?:Yes
Enumeration Date:2009-03-17
Last Update Date:2010-07-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist