Provider Demographics
NPI:1629200969
Name:SPOEHR, REBECCA L (PA-C)
Entity Type:Individual
Prefix:
First Name:REBECCA
Middle Name:L
Last Name:SPOEHR
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:211 PARK ST
Mailing Address - Street 2:
Mailing Address - City:ATTLEBORO
Mailing Address - State:MA
Mailing Address - Zip Code:02703-3143
Mailing Address - Country:US
Mailing Address - Phone:508-222-5200
Mailing Address - Fax:
Practice Address - Street 1:211 PARK ST
Practice Address - Street 2:
Practice Address - City:ATTLEBORO
Practice Address - State:MA
Practice Address - Zip Code:02703-3143
Practice Address - Country:US
Practice Address - Phone:508-222-5200
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-08-20
Last Update Date:2015-12-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RIPA00515363AM0700X
MAPA5024363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical