Provider Demographics
NPI:1326802596
Name:SPANGLER, CAROLINE MAINWARING
Entity Type:Individual
Prefix:
First Name:CAROLINE
Middle Name:MAINWARING
Last Name:SPANGLER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5004 SPRUCE DR
Mailing Address - Street 2:
Mailing Address - City:FAYETTEVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28304-2319
Mailing Address - Country:US
Mailing Address - Phone:910-705-1051
Mailing Address - Fax:
Practice Address - Street 1:5004 SPRUCE DR
Practice Address - Street 2:
Practice Address - City:FAYETTEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28304-2319
Practice Address - Country:US
Practice Address - Phone:910-705-1051
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-02-08
Last Update Date:2024-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC20631225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist