OrganizationHealth Spark, LlcChiropractorChiropractic ProvidersPractice Address4771 N Summit Way Ste 110, Meridian, ID 83646-5017(208) 994-4747PECOS EnrollmentBased on the most recent information from CMS, provider Health Spark, Llc does not have current enrollment records in PECOS.Part BMedicare Part BNot EnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentNot EnrolledPMDPower Mobility DeviceNot EnrolledCMS last updated its PECOS records 2 days ago.Profile DetailsProvider ID1205618840Provider TypeOrganizationFull NameHealth Spark, LlcSubpartNoEnumeration Date10/18/2023Last Updated10/23/2023Contact InformationPractice LocationPractice Address4771 N Summit Way Ste 110, Meridian, ID 83646-5017Phone(208) 994-4747FaxUnlisted FaxMailing LocationMailing Address4771 N Summit Way Ste 110, Meridian, ID 83646-5017Phone(208) 994-4747FaxUnlisted FaxAuthorized OfficialNameAllen, Russell (Owner)Phone(208) 994-4747Provider TaxonomiesCodeDescriptionLicenseCode111N00000XPrimaryDescriptionChiropractorChiropractic ProvidersLicenseUnlisted Issuer