Doctor Name: | MR. DANNY W SPEARS |
NPI Number: | 1215128269 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | |
License Number: | RG0043089 |
Business Practice Address: | 119 Benchoff Rd Graceville, FL - 324404601 |
Business Phone Number: | 8506380183 |
Business Fax Number: | |
Mailing Address: | 119 Benchoff Rd, GRACEVILLE |
State: | FL |
Postal Code: | 324404601 |
Phone Number: | 8506380183 |
Fax Number: | |
NPI Enumeration Date: | 08/06/2007 |
NPI Last Update Date: | 08/06/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 171WH0202X |
License Number: | RG0043089 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | FL |
Taxonomy Type: | Other Service Providers |
Taxonomy Classification: | Contractor |
Taxonomy Specialization: | Home Modifications |
Taxonomy Definition: |