Provider Demographics
NPI:1275060170
Name:SPURLIN, EFFIE J (LMBT)
Entity Type:Individual
Prefix:
First Name:EFFIE
Middle Name:J
Last Name:SPURLIN
Suffix:
Gender:F
Credentials:LMBT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7818B RENAISSANCE CT
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28226-3932
Mailing Address - Country:US
Mailing Address - Phone:704-724-1020
Mailing Address - Fax:
Practice Address - Street 1:7818B RENAISSANCE CT
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28226-3932
Practice Address - Country:US
Practice Address - Phone:704-724-1020
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-05-23
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC501225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC501OtherMASSAGE THERAPY