MEDICARE: THOMAS SPRAGUE

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101Y00000X	Counselor

General Provider Information

NPI Number	:	1588105613
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	THOMAS SPRAGUE

Provider Business Mailing Address
First Line	:	670 ROUTE 6A
Second Line	:
City	:	EAST SANDWICH
State	:	MA
Zip	:	02537-1436
Country	:	US
Telephone Number	:	508-503-2435
Fax Number	:	508-224-7956

Provider Business Practice Location Address
First Line	:	670 ROUTE 6A
Second Line	:
City	:	EAST SANDWICH
State	:	MA
Zip	:	02537-1436
Country	:	US
Telephone Number	:	508-503-2435
Fax Number	:	508-224-7956

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/08/2017
Last Update Date	:	03/08/2017

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Directions to “ THOMAS SPRAGUE ” Practice Location

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