Provider Demographics
NPI:1114249844
Name:SPEARS, CAROL JEANETTE (CMP)
Entity Type:Individual
Prefix:
First Name:CAROL
Middle Name:JEANETTE
Last Name:SPEARS
Suffix:
Gender:F
Credentials:CMP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:447 TREESIDE DR
Mailing Address - Street 2:
Mailing Address - City:STOW
Mailing Address - State:OH
Mailing Address - Zip Code:44224-1132
Mailing Address - Country:US
Mailing Address - Phone:330-929-4478
Mailing Address - Fax:
Practice Address - Street 1:447 TREESIDE DR
Practice Address - Street 2:
Practice Address - City:STOW
Practice Address - State:OH
Practice Address - Zip Code:44224-1132
Practice Address - Country:US
Practice Address - Phone:330-929-4478
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-02-22
Last Update Date:2010-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171W00000XOther Service ProvidersContractor