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General NPI Number Information
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NPI Number | 1427657881
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Entity Type | Individual
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Provider Name | DR. ROBERT SPACKMAN
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Gender | Male
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Dates
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Enumeration Date | 10/18/2020
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Last Update Date | 07/05/2021
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Provider Practice Location Address
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Address Line | 1485 GARDEN OF THE GODS RD STE 156
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City | COLORADO SPRINGS
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State | CO
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Zip | 80907-3306
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Country | US
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Telephone | 719-433-0750
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Fax |
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Provider Business Mailing Address
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Address Line | 1825 MAIN ST STE C
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City | COLORADO SPRINGS
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State | CO
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Zip | 80911-1100
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Country | US
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Telephone | 719-390-5404
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Fax | 719-390-8313
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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 | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | CHR.0008265
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License Number State | CO
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