Doctor Name: | DR. ILENE M. SPECTOR |
NPI Number: | 1477643799 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | D.O. |
License Number: | 2588 |
Business Practice Address: | 277a Blackstock Dr. Crested Butte, CO - 81224 |
Business Phone Number: | 9703492095 |
Business Fax Number: | 9703492095 |
Mailing Address: | 277a Blackstock Dr., CRESTED BUTTE |
State: | CO |
Postal Code: | 81224 |
Phone Number: | 9703492095 |
Fax Number: | 9703492095 |
NPI Enumeration Date: | 10/15/2006 |
NPI Last Update Date: | 01/26/2010 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 204D00000X |
License Number: | 2588 |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | AZ |
Taxonomy Type: | Allopathic & Osteopathic Physicians |
Taxonomy Classification: | Neuromusculoskeletal Medicine & OMM |
Taxonomy Specialization: | |
Taxonomy Definition: |