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NPI Code Detail

MEDICARE: TORI SPUNG LPN

MEDICARE: TORI SPUNG LPN
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
1164W00000XLicensed Practical NursePN.151812-M-IVOH

General Provider Information

NPI Number : 1336564707
Entity Type Code : Individual
Provider Name (Legal Business Name) : TORI SPUNG LPN
Provider Business Mailing Address
First Line : PO BOX 396
Second Line :
City : SPRINGBORO
State : OH
Zip : 45066-0396
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 3012 GLENMORE AVE STE 14
Second Line :
City : CINCINNATI
State : OH
Zip : 45238-2258
Country : US
Telephone Number : 513-221-2125
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/21/2014
Last Update Date : 09/11/2024

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