Provider Demographics
NPI:1508576885
Name:SPANGLER, KAYLIE J
Entity Type:Individual
Prefix:
First Name:KAYLIE
Middle Name:J
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 1:7020 OLD RIVER RD
Mailing Address - Street 2:
Mailing Address - City:PHILO
Mailing Address - State:OH
Mailing Address - Zip Code:43771-9725
Mailing Address - Country:US
Mailing Address - Phone:740-252-1474
Mailing Address - Fax:
Practice Address - Street 1:2158 COLUMBUS RD
Practice Address - Street 2:
Practice Address - City:GRANVILLE
Practice Address - State:OH
Practice Address - Zip Code:43023-1242
Practice Address - Country:US
Practice Address - Phone:740-321-0403
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-11-28
Last Update Date:2022-11-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant