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General NPI Number Information
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NPI Number | 1073077590
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Entity Type | Organization
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Legal Business Name | SPICER ORTHOPEDICS, LLC
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Dates
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Enumeration Date | 01/29/2019
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Last Update Date | 02/16/2026
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Provider Practice Location Address
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Address Line | 11237 FAIROAKS RD NE STE B
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City | BOLIVAR
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State | OH
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Zip | 44612-8767
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Country | US
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Telephone | 330-595-1010
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Fax | 330-595-1051
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Provider Business Mailing Address
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Address Line | 11736 STRASBURG BOLIVAR RD NW APT 1
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City | BOLIVAR
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State | OH
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Zip | 44612-8471
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Country | US
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Telephone | 330-904-9156
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Fax | 330-595-1051
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Authorized Official
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Title or Position | OWNER
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Name | KEVIN M SPICER
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Credential | LP, CP, COA
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Telephone | 330-595-1010
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 335E00000X
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Taxonomy Name | Prosthetic/Orthotic Supplier
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License Number |
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License Number State |
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