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NPI 1164973509

NPI 1164973509 : SPENCERS HOME MODIFICATIONS : TIFFIN, OH

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General NPI Number Information
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    NPI Number           |    1164973509
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    Entity Type          |    Organization 
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    Legal Business Name  |    SPENCERS HOME MODIFICATIONS 
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Dates
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    Enumeration Date     |    10/20/2016
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    Last Update Date     |    08/22/2025
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Provider Practice Location Address
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    Address Line         |    334 S WASHINGTON ST 
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    City                 |    TIFFIN
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    State                |    OH
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    Zip                  |    44883-3007
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    Country              |    US
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    Telephone            |    419-618-1050
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    334 S WASHINGTON ST 
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    City                 |    TIFFIN
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    State                |    OH
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    Zip                  |    44883-3007
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    Country              |    US
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    Telephone            |    419-618-1050
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    Fax                  |    
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Authorized Official
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    Title or Position    |    OWNER/OPERATOR
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    Name                 |     SCOTT ALLEN SPENCER 
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    Credential           |    
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    Telephone            |    419-618-1050
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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    Taxonomy Code        |    171WH0202X
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    Taxonomy Name        |    Home Modifications Contractor
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    License Number       |    
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    License Number State |    
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