Provider Demographics
NPI:1780711242
Name:SPRUILL, CHLOE HARPER (MPT)
Entity type:Individual
Prefix:MRS
First Name:CHLOE
Middle Name:HARPER
Last Name:SPRUILL
Suffix:
Gender:F
Credentials:MPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:141 MEADOWS DR
Mailing Address - Street 2:
Mailing Address - City:BOYNTON BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33436-9138
Mailing Address - Country:US
Mailing Address - Phone:561-703-7213
Mailing Address - Fax:
Practice Address - Street 1:7410 BOYNTON BEACH BLVD STE A11
Practice Address - Street 2:
Practice Address - City:BOYNTON BEACH
Practice Address - State:FL
Practice Address - Zip Code:33437-6157
Practice Address - Country:US
Practice Address - Phone:561-731-0163
Practice Address - Fax:561-731-1886
Is Sole Proprietor?:No
Enumeration Date:2007-02-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPT19340174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist