Provider Demographics
NPI:1225006166
Name:SPOONHOUR, DENNIS JR (DC)
Entity Type:Individual
Prefix:
First Name:DENNIS
Middle Name:
Last Name:SPOONHOUR
Suffix:JR
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2237 N COMMERCE PKWY
Mailing Address - Street 2:SUITE 2
Mailing Address - City:WESTON
Mailing Address - State:FL
Mailing Address - Zip Code:33326-3250
Mailing Address - Country:US
Mailing Address - Phone:954-888-6650
Mailing Address - Fax:954-888-6645
Practice Address - Street 1:2237 N COMMERCE PKWY
Practice Address - Street 2:SUITE 2
Practice Address - City:WESTON
Practice Address - State:FL
Practice Address - Zip Code:33326-3250
Practice Address - Country:US
Practice Address - Phone:954-888-6650
Practice Address - Fax:954-888-6645
Is Sole Proprietor?:No
Enumeration Date:2006-03-08
Last Update Date:2013-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH8366111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL890548059OtherTAX ID
FL890548059OtherTAX ID
FL70089Medicare PIN
FLU94482Medicare UPIN