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General NPI Number Information
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NPI Number | 1902580780
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Entity Type | Organization
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Legal Business Name | SPRADLING MEDICAL & TREATMENT LLC
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Dates
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Enumeration Date | 06/13/2023
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Last Update Date | 02/16/2024
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Provider Practice Location Address
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Address Line | 3536 TEAYS VALLEY RD
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City | HURRICANE
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State | WV
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Zip | 25526-9054
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Country | US
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Telephone | 304-962-1008
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Fax |
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Provider Business Mailing Address
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Address Line | 3536 TEAYS VALLEY RD
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City | HURRICANE
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State | WV
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Zip | 25526-9054
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Country | US
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Telephone | 304-962-1008
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Fax |
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Authorized Official
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Title or Position | FNP/ MEDICAL DIRECTOR
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Name | LISA SPRADLING
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Credential |
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Telephone | 304-962-1008
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QG0250X
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Taxonomy Name | Genetics Clinic/Center
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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 | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State |
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