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General NPI Number Information
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NPI Number | 1831193283
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Entity Type | Individual
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Provider Name | MICAH BRITT SPEARS CPO
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Gender | Male
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Dates
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Enumeration Date | 06/13/2005
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Last Update Date | 01/04/2008
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Provider Practice Location Address
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Address Line | 2000 HWY 25B. N. SUITE C-1
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City | HEBER SPRINGS
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State | AR
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Zip | 72543
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Country | US
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Telephone | 501-206-3500
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Fax | 501-206-3505
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Provider Business Mailing Address
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Address Line | 5402 BRANTFORD AVE.
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City | MEMPHIS
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State | TN
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Zip | 38120-2440
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Country | US
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Telephone | 901-767-3665
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Fax | 501-206-3505
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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 | 222Z00000X
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Taxonomy Name | Orthotist
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 224P00000X
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Taxonomy Name | Prosthetist
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License Number |
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License Number State |
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