Provider Demographics
NPI:1609285949
Name:SPUDIE, ERIKA (MED, ATC)
Entity Type:Individual
Prefix:
First Name:ERIKA
Middle Name:
Last Name:SPUDIE
Suffix:
Gender:F
Credentials:MED, ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1 COLLEGE ROAD
Mailing Address - Street 2:
Mailing Address - City:HAMPDEN-SYDNEY
Mailing Address - State:VA
Mailing Address - Zip Code:23943
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1 COLLEGE ROAD
Practice Address - Street 2:
Practice Address - City:HAMPDEN-SYDNEY
Practice Address - State:VA
Practice Address - Zip Code:23943
Practice Address - Country:US
Practice Address - Phone:419-283-3487
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-08-12
Last Update Date:2014-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA01260019932255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer