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General NPI Number Information
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NPI Number | 1124225925
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Entity Type | Organization
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Legal Business Name | JAMES R SPRADLING
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Dates
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Enumeration Date | 06/27/2007
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Last Update Date | 09/02/2009
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Provider Practice Location Address
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Address Line | 28525 LOS ANGELES AVE SUITE F
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City | WELLTON
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State | AZ
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Zip | 85356-0821
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Country | US
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Telephone | 928-581-2999
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 821 28525 LOS ANGELES AVE SUITE F
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City | WELLTON
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State | AZ
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Zip | 85356-0821
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Country | US
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Telephone | 928-581-2999
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Fax |
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Authorized Official
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Title or Position | CHIROPRACTOR
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Name | JAMES RANDALL SPRADLING
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Credential | D.C.
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Telephone | 928-581-2999
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QR1300X
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Taxonomy Name | Rural Health Clinic/Center
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License Number | 5080
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License Number State | AZ
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Taxonomy #2
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | 5080
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License Number State | AZ
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