MEDICARE: LINDA SPACIL

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	225X00000X	Occupational Therapist	0093	NV

General Provider Information

NPI Number	:	1699097980
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LINDA SPACIL

Provider Business Mailing Address
First Line	:	2236 NIGHT PARROT AVE
Second Line	:
City	:	NORTH LAS VEGAS
State	:	NV
Zip	:	89084-3805
Country	:	US
Telephone Number	:	702-375-2336
Fax Number	:	702-897-0905

Provider Business Practice Location Address
First Line	:	2236 NIGHT PARROT AVE
Second Line	:
City	:	NORTH LAS VEGAS
State	:	NV
Zip	:	89084-3805
Country	:	US
Telephone Number	:	702-375-2336
Fax Number	:	702-897-0905

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

Provider Enumeration Date	:	02/27/2010
Last Update Date	:	02/27/2010

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Directions to “ LINDA SPACIL ” Practice Location

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