Provider Demographics
NPI:1083267579
Name:SPERL, ANDREA RENEE (DC)
Entity Type:Individual
Prefix:
First Name:ANDREA
Middle Name:RENEE
Last Name:SPERL
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:ANDREA
Other - Middle Name:RENEE
Other - Last Name:GROF
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1223 HIGHWAY 60 W
Mailing Address - Street 2:
Mailing Address - City:FARIBAULT
Mailing Address - State:MN
Mailing Address - Zip Code:55021-4964
Mailing Address - Country:US
Mailing Address - Phone:507-384-3800
Mailing Address - Fax:
Practice Address - Street 1:1223 HIGHWAY 60 W
Practice Address - Street 2:
Practice Address - City:FARIBAULT
Practice Address - State:MN
Practice Address - Zip Code:55021-4964
Practice Address - Country:US
Practice Address - Phone:507-384-3800
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-07-23
Last Update Date:2020-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN6621111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor