Provider Demographics
NPI:1265837595
Name:SPRADLEY, JOE
Entity Type:Individual
Prefix:
First Name:JOE
Middle Name:
Last Name:SPRADLEY
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 333
Mailing Address - Street 2:
Mailing Address - City:CHANDLER
Mailing Address - State:TX
Mailing Address - Zip Code:75758-0333
Mailing Address - Country:US
Mailing Address - Phone:903-941-9374
Mailing Address - Fax:903-849-2011
Practice Address - Street 1:2360 HWY 315 S
Practice Address - Street 2:
Practice Address - City:CHANDLER
Practice Address - State:TX
Practice Address - Zip Code:75758
Practice Address - Country:US
Practice Address - Phone:903-941-9374
Practice Address - Fax:903-849-2011
Is Sole Proprietor?:No
Enumeration Date:2014-10-29
Last Update Date:2014-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171WH0202XOther Service ProvidersContractorHome Modifications