Provider Demographics
NPI:1164878476
Name:SPENCE, WAYNE (NMD)
Entity Type:Individual
Prefix:DR
First Name:WAYNE
Middle Name:
Last Name:SPENCE
Suffix:
Gender:M
Credentials:NMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4038 E HUBER ST
Mailing Address - Street 2:
Mailing Address - City:MESA
Mailing Address - State:AZ
Mailing Address - Zip Code:85205-4022
Mailing Address - Country:US
Mailing Address - Phone:480-654-6217
Mailing Address - Fax:480-654-6217
Practice Address - Street 1:7595 E MCDONALD DR
Practice Address - Street 2:SUITE 100
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85250-6004
Practice Address - Country:US
Practice Address - Phone:480-274-7256
Practice Address - Fax:480-654-6217
Is Sole Proprietor?:Yes
Enumeration Date:2016-05-05
Last Update Date:2016-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ08-1086175F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175F00000XOther Service ProvidersNaturopath