Provider Demographics
NPI:1922359124
Name:SPAULDING, DAVID (OTR)
Entity Type:Individual
Prefix:
First Name:DAVID
Middle Name:
Last Name:SPAULDING
Suffix:
Gender:M
Credentials:OTR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:188 THORNTON RD
Mailing Address - Street 2:
Mailing Address - City:HANOVER
Mailing Address - State:IN
Mailing Address - Zip Code:47243-9714
Mailing Address - Country:US
Mailing Address - Phone:812-866-8396
Mailing Address - Fax:
Practice Address - Street 1:188 THORNTON RD
Practice Address - Street 2:
Practice Address - City:HANOVER
Practice Address - State:IN
Practice Address - Zip Code:47243-9714
Practice Address - Country:US
Practice Address - Phone:812-866-8396
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-09-27
Last Update Date:2013-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN31003235A225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist