Provider Demographics
NPI:1336523489
Name:SPENCER, MARGARET (DC)
Entity Type:Individual
Prefix:
First Name:MARGARET
Middle Name:
Last Name:SPENCER
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:MARGARET
Other - Middle Name:
Other - Last Name:KUBERRA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DC
Mailing Address - Street 1:1003 E FREEWAY DR SE
Mailing Address - Street 2:SUITE B
Mailing Address - City:CONYERS
Mailing Address - State:GA
Mailing Address - Zip Code:30094-5927
Mailing Address - Country:US
Mailing Address - Phone:770-760-0060
Mailing Address - Fax:770-760-0409
Practice Address - Street 1:1003 E FREEWAY DR SE
Practice Address - Street 2:SUITE B
Practice Address - City:CONYERS
Practice Address - State:GA
Practice Address - Zip Code:30094-5927
Practice Address - Country:US
Practice Address - Phone:770-760-0060
Practice Address - Fax:770-760-0409
Is Sole Proprietor?:Yes
Enumeration Date:2015-07-17
Last Update Date:2016-05-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GACHIR009357111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor