NPI age
3 years
Enumerated 2023-03-23
● Active Type 2 · Organization
Subpart
Spark Med Spa, Llc
Spark Med Spa, Llc is 1 of 55 clinic/center organizations in Idaho.
Primary specialty
Clinic/Center
Practice locations
2
1 secondary on file
Status
Active
No deactivations on record
Authorized official
Garrett
Co-Owner/director
Last NPPES update
2025-05-28
Source: monthly bulk 2026-05
How this organization compares
Across 55 active clinic/center providers in Idaho.
NPI age
3 years
↓ 6 yr below median
Practice locations
2
1 secondary on file
Subspecialties
0
NPI lifetime · 2023 → 2026
2023-03Enumerated in NPPES
2023
2026
Where they practice
Primary practice location
8027 N Government Way, Suite 106
Hayden, ID 83835
Mailing address
Po Box 1021
Athol, ID 838016009
Additional practice locations
1 secondary location on file with NPPES.
Location 2
1352 E Center St Ste B
Pocatello, ID 832014702
Authorized official
Robbie J Garrett, RN
Co-Owner/director
📞 2082512660
Specialties
-
Clinic/Center PrimaryDefinition to come...
Other names on file (2)
Doing-business-as, former, and alternate names recorded by NPPES.
-
Spark Med Spa
-
Spark Med Spa
Practice context
Multi-site organization. 1 additional practice location on file.
Subpart of Spark Med Spa, Llc.
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- Confirm the NPI on NPPES.The CMS registry is the system of record. Open NPPES →
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