Provider Demographics
NPI:1619075611
Name:SPURGIN, SHIRLEY R (DC)
Entity Type:Individual
Prefix:
First Name:SHIRLEY
Middle Name:R
Last Name:SPURGIN
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:809 EAST LATHAM AVE
Mailing Address - Street 2:
Mailing Address - City:HEMET
Mailing Address - State:CA
Mailing Address - Zip Code:92543
Mailing Address - Country:US
Mailing Address - Phone:951-658-7219
Mailing Address - Fax:951-658-7210
Practice Address - Street 1:809 EAST LATHAM AVE
Practice Address - Street 2:
Practice Address - City:HEMET
Practice Address - State:CA
Practice Address - Zip Code:92543
Practice Address - Country:US
Practice Address - Phone:951-658-7219
Practice Address - Fax:951-658-7210
Is Sole Proprietor?:No
Enumeration Date:2006-09-21
Last Update Date:2010-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC16068111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
T18238Medicare UPIN
CADC0160680Medicare ID - Type Unspecified