| Doctor Name: | MR. JUSTIN LONN SPOONER |
| NPI Number: | 1134134836 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | L.P.T. |
| License Number: | PT2055 |
| Business Practice Address: | 621 Se Port St Lucie Blvd Port Saint Lucie, FL - 349845141 |
| Business Phone Number: | 7723438000 |
| Business Fax Number: | 7723437999 |
| Mailing Address: | 621 Se Port St Lucie Blvd, PORT SAINT LUCIE |
| State: | FL |
| Postal Code: | 349845141 |
| Phone Number: | 7723438000 |
| Fax Number: | 7723437999 |
| NPI Enumeration Date: | 07/30/2006 |
| NPI Last Update Date: | 12/09/2009 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 2251X0800X |
| License Number: | PT2055 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | FL |
| Taxonomy Type: | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Taxonomy Classification: | Physical Therapist |
| Taxonomy Specialization: | Orthopedic |
| Taxonomy Definition: | |