Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2251X0800X | Physical Therapist - Orthopedic | PT30410 | CA |
NPI | 1063504421 |
---|---|
Provider Name | Robert A. Sparrow |
First Address | Santa Barbara, CA 93110-1442 |
Second Address | Goleta, CA 93117-5902 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 29/09/2006 |
Last Update Date | 08/07/2007 |