Provider Demographics
NPI:1417456211
Name:SPREEN, DOUGLAS STEVEN (ATC)
Entity Type:Individual
Prefix:
First Name:DOUGLAS
Middle Name:STEVEN
Last Name:SPREEN
Suffix:
Gender:M
Credentials:ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:955 ELM CT
Mailing Address - Street 2:
Mailing Address - City:TERRACE PARK
Mailing Address - State:OH
Mailing Address - Zip Code:45174-1069
Mailing Address - Country:US
Mailing Address - Phone:513-225-3446
Mailing Address - Fax:
Practice Address - Street 1:955 ELM CT
Practice Address - Street 2:
Practice Address - City:TERRACE PARK
Practice Address - State:OH
Practice Address - Zip Code:45174-1069
Practice Address - Country:US
Practice Address - Phone:513-225-3446
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-02-07
Last Update Date:2018-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHATC0006252255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer