Provider Demographics
NPI:1184730434
Name:SPEES, TODD MICHAEL
Entity type:Individual
Prefix:MR
First Name:TODD
Middle Name:MICHAEL
Last Name:SPEES
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:104 WATERFORD CT
Mailing Address - Street 2:
Mailing Address - City:BONAIRE
Mailing Address - State:GA
Mailing Address - Zip Code:31005-3624
Mailing Address - Country:US
Mailing Address - Phone:478-922-8103
Mailing Address - Fax:
Practice Address - Street 1:104 WATERFORD CT
Practice Address - Street 2:
Practice Address - City:BONAIRE
Practice Address - State:GA
Practice Address - Zip Code:31005-3624
Practice Address - Country:US
Practice Address - Phone:478-922-8103
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225800000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRecreation Therapist