Provider Demographics
NPI:1649776808
Name:SPROUL, COURTNEY D (DC)
Entity Type:Individual
Prefix:
First Name:COURTNEY
Middle Name:D
Last Name:SPROUL
Suffix:
Gender:F
Credentials:DC
Other - Prefix:DR
Other - First Name:COURTNEY
Other - Middle Name:D
Other - Last Name:MARTIN
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DC
Mailing Address - Street 1:5318 114TH ST
Mailing Address - Street 2:
Mailing Address - City:LUBBOCK
Mailing Address - State:TX
Mailing Address - Zip Code:79424-6621
Mailing Address - Country:US
Mailing Address - Phone:806-783-0644
Mailing Address - Fax:
Practice Address - Street 1:5318 114TH ST
Practice Address - Street 2:
Practice Address - City:LUBBOCK
Practice Address - State:TX
Practice Address - Zip Code:79424-6621
Practice Address - Country:US
Practice Address - Phone:806-783-0644
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-04-04
Last Update Date:2024-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX13703111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor