Provider Demographics
NPI:1700584844
Name:SPEARS, MARTHA A
Entity Type:Individual
Prefix:
First Name:MARTHA
Middle Name:A
Last Name:SPEARS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1530 WALMART DR
Mailing Address - Street 2:
Mailing Address - City:LEBANON
Mailing Address - State:OH
Mailing Address - Zip Code:45036-7342
Mailing Address - Country:US
Mailing Address - Phone:513-932-2993
Mailing Address - Fax:513-932-3153
Practice Address - Street 1:1530 WALMART DR
Practice Address - Street 2:
Practice Address - City:LEBANON
Practice Address - State:OH
Practice Address - Zip Code:45036-7342
Practice Address - Country:US
Practice Address - Phone:513-932-2993
Practice Address - Fax:513-932-3153
Is Sole Proprietor?:Yes
Enumeration Date:2023-02-17
Last Update Date:2023-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes156FX1800XEye and Vision Services ProvidersTechnician/TechnologistOptician