MEDICARE: LEE ANN SPOLYAR

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	104100000X	Social Worker	6851119437	MI

General Provider Information

NPI Number	:	1285522219
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LEE ANN SPOLYAR

Provider Business Mailing Address
First Line	:	20 DIVISION ST
Second Line	:
City	:	COLDWATER
State	:	MI
Zip	:	49036-1966
Country	:	US
Telephone Number	:	269-489-8311
Fax Number	:	269-489-8311

Provider Business Practice Location Address
First Line	:	20 DIVISION ST
Second Line	:
City	:	COLDWATER
State	:	MI
Zip	:	49036-1966
Country	:	US
Telephone Number	:	269-489-8311
Fax Number	:	269-489-8311

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

Provider Enumeration Date	:	06/26/2025
Last Update Date	:	06/26/2025

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Directions to “ LEE ANN SPOLYAR ” Practice Location

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