MEDICARE: DENNIS SPOONHOUR JR. DC

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	111N00000X	Chiropractor	CH8366	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	890548059	OTHER	FL	TAX ID

General Provider Information

NPI Number	:	1225006166
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DENNIS SPOONHOUR JR. DC

Provider Business Mailing Address
First Line	:	2237 N COMMERCE PKWY
Second Line	:	SUITE 2
City	:	WESTON
State	:	FL
Zip	:	33326-3250
Country	:	US
Telephone Number	:	954-888-6650
Fax Number	:	954-888-6645

Provider Business Practice Location Address
First Line	:	2237 N COMMERCE PKWY
Second Line	:	SUITE 2
City	:	WESTON
State	:	FL
Zip	:	33326-3250
Country	:	US
Telephone Number	:	954-888-6650
Fax Number	:	954-888-6645

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

Provider Enumeration Date	:	03/08/2006
Last Update Date	:	05/06/2013

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Directions to “ DENNIS SPOONHOUR JR. DC” Practice Location

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