Provider Demographics
NPI:1285980284
Name:SPRAGGINS, JULIAN KYLE (DPT)
Entity type:Individual
Prefix:
First Name:JULIAN
Middle Name:KYLE
Last Name:SPRAGGINS
Suffix:
Gender:M
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:729 FAIRMONT RD STE 101
Mailing Address - Street 2:
Mailing Address - City:MORGANTOWN
Mailing Address - State:WV
Mailing Address - Zip Code:26501-4588
Mailing Address - Country:US
Mailing Address - Phone:304-413-4515
Mailing Address - Fax:304-413-4501
Practice Address - Street 1:729 FAIRMONT RD STE 101
Practice Address - Street 2:
Practice Address - City:MORGANTOWN
Practice Address - State:WV
Practice Address - Zip Code:26501-4588
Practice Address - Country:US
Practice Address - Phone:304-413-4515
Practice Address - Fax:304-413-4501
Is Sole Proprietor?:No
Enumeration Date:2012-07-27
Last Update Date:2022-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD26978225100000X
WV003062225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist