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NPI Code Detail

MEDICARE: TRUDIE R SPENCER LPTA

MEDICARE: TRUDIE R SPENCER LPTA
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1225200000XPhysical Therapy AssistantPTA-5557OH
2225200000XPhysical Therapy Assistant06003476AIN

General Provider Information

NPI Number : 1144354259
Entity Type Code : Individual
Provider Name (Legal Business Name) : TRUDIE R SPENCER LPTA
Provider Business Mailing Address
First Line : PO BOX 161
Second Line :
City : UNIOPOLIS
State : OH
Zip : 45888-0161
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 333 1ST ST N
Second Line : SUITE 200
City : JACKSONVILLE BEACH
State : FL
Zip : 32250-6945
Country : US
Telephone Number : 888-909-5038
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/14/2007
Last Update Date : 09/11/2025

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Directions to “ TRUDIE R SPENCER LPTA” Practice Location

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