Provider Demographics
NPI:1750172649
Name:T AND L WAKEFIELD LLC
Entity type:Organization
Organization Name:T AND L WAKEFIELD LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BILLING MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:JUANITA
Authorized Official - Middle Name:
Authorized Official - Last Name:SPURGEON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:715-298-6465
Mailing Address - Street 1:5295 ADMIRALS LNDG
Mailing Address - Street 2:
Mailing Address - City:LANCASTER
Mailing Address - State:SC
Mailing Address - Zip Code:29720-6325
Mailing Address - Country:US
Mailing Address - Phone:715-661-2393
Mailing Address - Fax:
Practice Address - Street 1:5295 ADMIRALS LNDG
Practice Address - Street 2:
Practice Address - City:LANCASTER
Practice Address - State:SC
Practice Address - Zip Code:29720-6325
Practice Address - Country:US
Practice Address - Phone:715-661-2393
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-05-13
Last Update Date:2025-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty