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General NPI Number Information
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NPI Number | 1003607334
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Entity Type | Individual
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Provider Name | SPENCER SHELL MASSAGE THERAPY
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Gender | Male
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Dates
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Enumeration Date | 05/15/2025
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Last Update Date | 05/15/2025
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Provider Practice Location Address
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Address Line | 5300 S SOUTHERN HILLS CT STE 200
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City | ROGERS
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State | AR
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Zip | 72758-3500
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Country | US
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Telephone | 479-636-1324
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Fax | 479-631-0014
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Provider Business Mailing Address
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Address Line | 5300 S SOUTHERN HILLS CT STE 200
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City | ROGERS
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State | AR
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Zip | 72758-3500
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225700000X
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Taxonomy Name | Massage Therapist
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License Number | 8516
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License Number State | AR
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