MEDICARE: JAMES JOSEPH SPOERL LPT

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	225100000X	Physical Therapist	003468	OH

General Provider Information

NPI Number	:	1811101553
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JAMES JOSEPH SPOERL LPT

Provider Business Mailing Address
First Line	:	1930 PEARL RD STE 2
Second Line	:
City	:	BRUNSWICK
State	:	OH
Zip	:	44212-6477
Country	:	US
Telephone Number	:	330-220-2001
Fax Number	:	330-220-2232

Provider Business Practice Location Address
First Line	:	1930 PEARL RD STE 2
Second Line	:
City	:	BRUNSWICK
State	:	OH
Zip	:	44212-6477
Country	:	US
Telephone Number	:	330-220-2001
Fax Number	:	330-220-2232

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

Provider Enumeration Date	:	05/10/2007
Last Update Date	:	07/08/2007

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Directions to “ JAMES JOSEPH SPOERL LPT” Practice Location

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