Provider Demographics
NPI:1639542186
Name:SPITTERS, ACASSI ROSE
Entity Type:Individual
Prefix:
First Name:ACASSI
Middle Name:ROSE
Last Name:SPITTERS
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 1:808 VAN BRUNT AVE
Mailing Address - Street 2:
Mailing Address - City:SAINT JOSEPH
Mailing Address - State:MI
Mailing Address - Zip Code:49085-2014
Mailing Address - Country:US
Mailing Address - Phone:405-200-5668
Mailing Address - Fax:
Practice Address - Street 1:808 VAN BRUNT AVE
Practice Address - Street 2:
Practice Address - City:SAINT JOSEPH
Practice Address - State:MI
Practice Address - Zip Code:49085-2014
Practice Address - Country:US
Practice Address - Phone:405-200-5668
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-11-05
Last Update Date:2015-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes247200000XTechnologists, Technicians & Other Technical Service ProvidersTechnician, Other