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General NPI Number Information
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NPI Number | 1174252712
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Entity Type | Individual
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Provider Name | SPENCER HUNTER
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Gender | Male
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Dates
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Enumeration Date | 06/08/2022
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Last Update Date | 06/08/2022
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Provider Practice Location Address
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Address Line | 21607 LEE ST
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City | SOUTH CHESTERFIELD
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State | VA
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Zip | 23803-8033
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Country | US
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Telephone | 804-721-8351
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 171
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City | SUTHERLAND
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State | VA
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Zip | 23885-0171
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Country | US
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Telephone | 804-721-8351
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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 | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number |
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License Number State | VA
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