Provider Demographics
NPI:1336257807
Name:BURLING, SPENCER RYANN (DC)
Entity Type:Individual
Prefix:DR
First Name:SPENCER
Middle Name:RYANN
Last Name:BURLING
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1003 ST.JAMES AVE, UNIT 2
Mailing Address - Street 2:
Mailing Address - City:SPRINGFIELD
Mailing Address - State:MA
Mailing Address - Zip Code:01104
Mailing Address - Country:US
Mailing Address - Phone:413-455-3625
Mailing Address - Fax:413-317-7488
Practice Address - Street 1:1003 SAINT JAMES AVE UNIT 2
Practice Address - Street 2:
Practice Address - City:SPRINGFIELD
Practice Address - State:MA
Practice Address - Zip Code:01104-2145
Practice Address - Country:US
Practice Address - Phone:413-455-3625
Practice Address - Fax:413-317-7488
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-26
Last Update Date:2018-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA2798111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
MAY45622Medicare ID - Type Unspecified