MEDICARE: MR. SCOTT WOODWARD SPENCE M.A.-CCC-A

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	231H00000X	Audiologist	A-00487	OH

General Provider Information

NPI Number	:	1861837056
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. SCOTT WOODWARD SPENCE M.A.-CCC-A

Provider Business Mailing Address
First Line	:	809 COSHOCTON AVE
Second Line	:	SUITE F
City	:	MOUNT VERNON
State	:	OH
Zip	:	43050-1900
Country	:	US
Telephone Number	:	740-392-4572
Fax Number	:

Provider Business Practice Location Address
First Line	:	809 COSHOCTON AVE
Second Line	:	SUITE F
City	:	MOUNT VERNON
State	:	OH
Zip	:	43050-1900
Country	:	US
Telephone Number	:	740-392-4572
Fax Number	:

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

Provider Enumeration Date	:	05/02/2013
Last Update Date	:	01/11/2017

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