Provider Demographics
NPI:1437570462
Name:CALLAHAN, SPENCER ROBERT (DC)
Entity Type:Individual
Prefix:DR
First Name:SPENCER
Middle Name:ROBERT
Last Name:CALLAHAN
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7 S BAYVIEW ST
Mailing Address - Street 2:
Mailing Address - City:FAIRHOPE
Mailing Address - State:AL
Mailing Address - Zip Code:36532-3401
Mailing Address - Country:US
Mailing Address - Phone:251-990-2275
Mailing Address - Fax:251-338-1175
Practice Address - Street 1:7 S BAYVIEW ST
Practice Address - Street 2:
Practice Address - City:FAIRHOPE
Practice Address - State:AL
Practice Address - Zip Code:36532-3401
Practice Address - Country:US
Practice Address - Phone:251-990-2275
Practice Address - Fax:251-338-1175
Is Sole Proprietor?:Yes
Enumeration Date:2013-12-17
Last Update Date:2013-12-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL2410111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor