Healthcare Provider Details

I. General information

NPI: 1306108444
Provider Name (Legal Business Name): LUCINDA PAULINE SPURGEON OT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/14/2012
Last Update Date: 06/14/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6281 TRI RIDGE BLVD
LOVELAND OH
45140-8345
US

IV. Provider business mailing address

594 VIRGINIA LN
CINCINNATI OH
45244-1328
US

V. Phone/Fax

Practice location:
  • Phone: 866-791-5766
  • Fax:
Mailing address:
  • Phone: 513-508-7431
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number6165
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: