Provider Demographics
NPI:1477744993
Name:SPENCER, STEVEN ALLAN (MPT)
Entity Type:Individual
Prefix:
First Name:STEVEN
Middle Name:ALLAN
Last Name:SPENCER
Suffix:
Gender:M
Credentials:MPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5314 S EL CAMINO DR
Mailing Address - Street 2:
Mailing Address - City:TEMPE
Mailing Address - State:AZ
Mailing Address - Zip Code:85283-1823
Mailing Address - Country:US
Mailing Address - Phone:480-220-6897
Mailing Address - Fax:
Practice Address - Street 1:5314 S EL CAMINO DR
Practice Address - Street 2:
Practice Address - City:TEMPE
Practice Address - State:AZ
Practice Address - Zip Code:85283-1823
Practice Address - Country:US
Practice Address - Phone:480-220-6897
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-08-08
Last Update Date:2007-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ5888225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist