Healthcare Provider Details

I. General information

NPI: 1285656298
Provider Name (Legal Business Name): JAMES CLIFFORD SPENCER JR. D.C.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/25/2006
Last Update Date: 11/15/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

509 S MERIDIAN RD
HUDSON MI
49247-9341
US

IV. Provider business mailing address

PO BOX 111
HUDSON MI
49247-0111
US

V. Phone/Fax

Practice location:
  • Phone: 517-448-3000
  • Fax: 517-448-6900
Mailing address:
  • Phone: 517-448-3000
  • Fax: 517-448-6900

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number2301005974
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: