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General NPI Number Information
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NPI Number | 1881870616
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Entity Type | Organization
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Legal Business Name | SPEARS PROSTHETICS AND ORTHOTICS
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Dates
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Enumeration Date | 01/10/2008
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Last Update Date | 04/20/2008
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Provider Practice Location Address
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Address Line | 2000 HIGHWAY 25B SUITE C-1
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City | HEBER SPRINGS
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State | AR
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Zip | 72543-6417
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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 | PO BOX 770237
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City | MEMPHIS
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State | TN
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Zip | 38177-0237
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | PRESIDENT/ CPO
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Name | MICAH B SPEARS
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Credential |
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Telephone | 501-206-3500
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 335E00000X
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Taxonomy Name | Prosthetic/Orthotic Supplier
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License Number |
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License Number State | AR
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