Provider Demographics
NPI:1285860015
Name:SPURLING, GREG KEITH (PTA MSS ATC/L EMT)
Entity Type:Individual
Prefix:MR
First Name:GREG
Middle Name:KEITH
Last Name:SPURLING
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Gender:M
Credentials:PTA MSS ATC/L EMT
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Mailing Address - Street 1:8823 PRODUCTION LN
Mailing Address - Street 2:
Mailing Address - City:OOLTEWAH
Mailing Address - State:TN
Mailing Address - Zip Code:37363-6511
Mailing Address - Country:US
Mailing Address - Phone:423-238-7217
Mailing Address - Fax:423-238-3473
Practice Address - Street 1:1430 VOLUNTEER PKWY
Practice Address - Street 2:STE 6
Practice Address - City:BRISTOL
Practice Address - State:TN
Practice Address - Zip Code:37620-6067
Practice Address - Country:US
Practice Address - Phone:423-652-0265
Practice Address - Fax:423-652-0574
Is Sole Proprietor?:No
Enumeration Date:2009-06-08
Last Update Date:2015-06-12
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Provider Licenses
StateLicense IDTaxonomies
VA0695026642255A2300X
TN6018225200000X
TN5402255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant
No2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer