Provider Demographics
NPI:1689321911
Name:SPURLOCK, ALAH DENISE
Entity Type:Individual
Prefix:
First Name:ALAH
Middle Name:DENISE
Last Name:SPURLOCK
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 1:2350 10TH AVE
Mailing Address - Street 2:
Mailing Address - City:HUNTINGTON
Mailing Address - State:WV
Mailing Address - Zip Code:25703-2044
Mailing Address - Country:US
Mailing Address - Phone:304-208-1022
Mailing Address - Fax:
Practice Address - Street 1:2350 10TH AVE
Practice Address - Street 2:
Practice Address - City:HUNTINGTON
Practice Address - State:WV
Practice Address - Zip Code:25703-2044
Practice Address - Country:US
Practice Address - Phone:304-208-1022
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-03-07
Last Update Date:2022-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant