| Doctor Name: | MR. DEAN SPANGLE |
| NPI Number: | 1033126131 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | MS, RD, CD |
| License Number: | 1334-029 |
| Business Practice Address: | 1617 73rd St Kenosha, WI - 531435363 |
| Business Phone Number: | 2626531771 |
| Business Fax Number: | |
| Mailing Address: | 1617 73rd St, KENOSHA |
| State: | WI |
| Postal Code: | 531435363 |
| Phone Number: | 2626531771 |
| Fax Number: | |
| NPI Enumeration Date: | 08/02/2006 |
| NPI Last Update Date: | 07/08/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 133VN1006X |
| License Number: | 1334-029 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | WI |
| Taxonomy Type: | Dietary & Nutritional Service Providers |
| Taxonomy Classification: | Dietitian, Registered |
| Taxonomy Specialization: | Nutrition, Metabolic |
| Taxonomy Definition: | |