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General NPI Number Information
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NPI Number | 1659333557
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Entity Type | Individual
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Provider Name | BRANT D. SPENCER D.C. P.C.
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Gender | Male
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Dates
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Enumeration Date | 04/05/2006
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Last Update Date | 08/15/2014
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Provider Practice Location Address
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Address Line | 104 S. MAIN
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City | BLANCHARD
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State | OK
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Zip | 73010
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Country | US
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Telephone | 405-485-9646
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Fax | 405-485-3464
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Provider Business Mailing Address
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Address Line | P.O. BOX 1548
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City | BLANCHARD
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State | OK
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Zip | 73010
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Country | US
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Telephone | 405-485-9646
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Fax | 405-485-3464
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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 | 3306
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License Number State | OK
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