Provider Demographics
NPI:1508553223
Name:MARUGG, SPENCER MATTHEW (DC)
Entity Type:Individual
Prefix:
First Name:SPENCER
Middle Name:MATTHEW
Last Name:MARUGG
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 1:2205 IVY LN
Mailing Address - Street 2:
Mailing Address - City:FINDLAY
Mailing Address - State:OH
Mailing Address - Zip Code:45840-4463
Mailing Address - Country:US
Mailing Address - Phone:386-316-7239
Mailing Address - Fax:
Practice Address - Street 1:2205 IVY LN
Practice Address - Street 2:
Practice Address - City:FINDLAY
Practice Address - State:OH
Practice Address - Zip Code:45840-4463
Practice Address - Country:US
Practice Address - Phone:386-316-7239
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-04-21
Last Update Date:2023-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHDC-05230111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor