Spark Med Spa, LLC
NPI #1376246884 in Hayden, Idaho
Provider Information
- NPI Number
- 1376246884
- Entity Type
- Organization
- Organization Name
- Spark Med Spa, LLC
- Subpart
- Yes (part of a larger organization)
- Parent Organization
- SPARK MED SPA, LLC
- Primary Specialty
- Clinic/Center - Health Service
- Enumeration Date
- Mar 23, 2023
- Last Updated
- May 28, 2025
Practice Location
Authorized Official
- Name
- ROBBIE J GARRETT, RN
- Title
- CO-OWNER/DIRECTOR
- Phone
- (208) 251-2660
Specialties & Taxonomy Codes
| Specialty |
|---|
| Clinic/Center - Health Service — Health Service |
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