MEDICARE: DR. JAMES NATHANAEL SPRAGUE 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	3489	NC
2	111N00000X	Chiropractor	9907	TX

General Provider Information

NPI Number	:	1568412328
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JAMES NATHANAEL SPRAGUE DC

Provider Business Mailing Address
First Line	:	328 CLAMDIGGER CRT
Second Line	:
City	:	SWANSBORO
State	:	NC
Zip	:	28584
Country	:	US
Telephone Number	:	252-646-5337
Fax Number	:

Provider Business Practice Location Address
First Line	:	5039 EXECUTIVE DRIVE
Second Line	:	SUITE 300
City	:	MOREHEAD CITY
State	:	NC
Zip	:	28557
Country	:	US
Telephone Number	:	252-808-2888
Fax Number	:	252-808-3106

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

Provider Enumeration Date	:	05/11/2006
Last Update Date	:	08/23/2011

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