=====================================================
General NPI Number Information
=====================================================
NPI Number | 1407094477
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | ROMY V. SPITZ
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 01/29/2009
-----------------------------------------------------
Last Update Date | 01/29/2009
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 20 WHEELER PARK
-----------------------------------------------------
City | BRUNSWICK
-----------------------------------------------------
State | ME
-----------------------------------------------------
Zip | 04011-1662
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 207-725-7236
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 20 WHEELER PARK
-----------------------------------------------------
City | BRUNSWICK
-----------------------------------------------------
State | ME
-----------------------------------------------------
Zip | 04011-1662
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 207-725-7236
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | PROPRIETOR
-----------------------------------------------------
Name | DR. ROMY VICTORIA SPITZ
-----------------------------------------------------
Credential | PH.D.
-----------------------------------------------------
Telephone | 207-725-7236
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 174400000X
-----------------------------------------------------
Taxonomy Name | Specialist
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------