Provider Demographics
NPI:1568412328
Name:SPRAGUE, JAMES NATHANAEL (DC)
Entity Type:Individual
Prefix:DR
First Name:JAMES
Middle Name:NATHANAEL
Last Name:SPRAGUE
Suffix:
Gender:M
Credentials:DC
Other - Prefix:DR
Other - First Name:JAMES
Other - Middle Name:NATHANAEL
Other - Last Name:SPRAGUE
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DC
Mailing Address - Street 1:328 CLAMDIGGER CRT
Mailing Address - Street 2:
Mailing Address - City:SWANSBORO
Mailing Address - State:NC
Mailing Address - Zip Code:28584
Mailing Address - Country:US
Mailing Address - Phone:252-646-5337
Mailing Address - Fax:
Practice Address - Street 1:5039 EXECUTIVE DRIVE
Practice Address - Street 2:SUITE 300
Practice Address - City:MOREHEAD CITY
Practice Address - State:NC
Practice Address - Zip Code:28557
Practice Address - Country:US
Practice Address - Phone:252-808-2888
Practice Address - Fax:252-808-3106
Is Sole Proprietor?:No
Enumeration Date:2006-05-11
Last Update Date:2011-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC3489111N00000X
TX9907111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor