MEDICARE: SPENCER CARRIER DPT

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	2251X0800X	Orthopedic Physical Therapist

General Provider Information

NPI Number	:	1326653387
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SPENCER CARRIER DPT

Provider Business Mailing Address
First Line	:	4175 SOUTH ALAMO AVENUE
Second Line	:
City	:	DAVIS-MONTHAN AIR FORCE BASE
State	:	AZ
Zip	:	85707-4405
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	4175 SOUTH ALAMO AVENUE
Second Line	:
City	:	DAVIS-MONTHAN AIR FORCE BASE
State	:	AZ
Zip	:	85707-4405
Country	:	US
Telephone Number	:	520-228-2886
Fax Number	:

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

Provider Enumeration Date	:	09/15/2020
Last Update Date	:	07/07/2023

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Directions to “ SPENCER CARRIER DPT” Practice Location

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