Provider Demographics
NPI:1932551199
Name:SPANBURGH-HESS, SYRENA DAWN (LAT, ATC)
Entity Type:Individual
Prefix:
First Name:SYRENA
Middle Name:DAWN
Last Name:SPANBURGH-HESS
Suffix:
Gender:F
Credentials:LAT, ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:340 OAKWOOD DR
Mailing Address - Street 2:
Mailing Address - City:WHITEHALL
Mailing Address - State:PA
Mailing Address - Zip Code:18052-7216
Mailing Address - Country:US
Mailing Address - Phone:484-547-4161
Mailing Address - Fax:
Practice Address - Street 1:1162 EDEN TER
Practice Address - Street 2:
Practice Address - City:ROCK HILL
Practice Address - State:SC
Practice Address - Zip Code:29730-3208
Practice Address - Country:US
Practice Address - Phone:803-323-2129
Practice Address - Fax:803-323-3933
Is Sole Proprietor?:No
Enumeration Date:2016-07-11
Last Update Date:2016-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC17702255A2300X
PART0061562255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer