Provider Demographics
NPI:1891189023
Name:SPANGLER, SARA (LMT)
Entity Type:Individual
Prefix:
First Name:SARA
Middle Name:
Last Name:SPANGLER
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1910 E BARNETT RD
Mailing Address - Street 2:STE. 103
Mailing Address - City:MEDFORD
Mailing Address - State:OR
Mailing Address - Zip Code:97504-8672
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1910 E BARNETT RD
Practice Address - Street 2:STE. 103
Practice Address - City:MEDFORD
Practice Address - State:OR
Practice Address - Zip Code:97504-8672
Practice Address - Country:US
Practice Address - Phone:541-245-9544
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-03-25
Last Update Date:2015-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR20928174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist