Provider Demographics
NPI:1174038574
Name:SPITZLEY, BETH ANN (PHYSICAL THERAPIST)
Entity Type:Individual
Prefix:MS
First Name:BETH
Middle Name:ANN
Last Name:SPITZLEY
Suffix:
Gender:F
Credentials:PHYSICAL THERAPIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:129 COX BLVD
Mailing Address - Street 2:
Mailing Address - City:LANSING
Mailing Address - State:MI
Mailing Address - Zip Code:48910-7401
Mailing Address - Country:US
Mailing Address - Phone:517-402-1741
Mailing Address - Fax:
Practice Address - Street 1:4655 DOBIE RD STE 270
Practice Address - Street 2:
Practice Address - City:OKEMOS
Practice Address - State:MI
Practice Address - Zip Code:48864-6909
Practice Address - Country:US
Practice Address - Phone:517-402-1741
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-12-06
Last Update Date:2017-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5501007432225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist