Provider Demographics
NPI:1013972686
Name:ADAMS SPENCER, BETH (DC)
Entity type:Individual
Prefix:
First Name:BETH
Middle Name:
Last Name:ADAMS SPENCER
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:480 W. NAVAJO
Mailing Address - Street 2:SUITE B
Mailing Address - City:WEST LAFAYETTE
Mailing Address - State:IN
Mailing Address - Zip Code:47906
Mailing Address - Country:US
Mailing Address - Phone:765-463-1370
Mailing Address - Fax:765-497-2898
Practice Address - Street 1:480 W. NAVAJO ST
Practice Address - Street 2:SUITE B
Practice Address - City:WEST LAFAYETTE
Practice Address - State:IN
Practice Address - Zip Code:47906-1940
Practice Address - Country:US
Practice Address - Phone:765-463-1370
Practice Address - Fax:765-497-2898
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-04-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN08002169A111N00000X
MN4568111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN233260AMedicare ID - Type Unspecified
V04758Medicare UPIN