MEDICARE: DR. WAYNE SPENCE NMD

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
1	175F00000X	Naturopath	08-1086	AZ

General Provider Information

NPI Number	:	1164878476
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. WAYNE SPENCE NMD

Provider Business Mailing Address
First Line	:	4038 E HUBER ST
Second Line	:
City	:	MESA
State	:	AZ
Zip	:	85205-4022
Country	:	US
Telephone Number	:	480-654-6217
Fax Number	:	480-654-6217

Provider Business Practice Location Address
First Line	:	7595 E MCDONALD DR
Second Line	:	SUITE 100
City	:	SCOTTSDALE
State	:	AZ
Zip	:	85250-6004
Country	:	US
Telephone Number	:	480-274-7256
Fax Number	:	480-654-6217

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/05/2016
Last Update Date	:	05/05/2016

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Directions to “ DR. WAYNE SPENCE NMD” Practice Location

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