Individual
JIM MICHAEL SPOOR
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
EMT
Contact information
Practice address
18 CLIFFORD ST, ELLENVILLE, NY 12428-2602
(845) 210-1056
Mailing address
18 CLIFFORD ST, ELLENVILLE, NY 12428-2602
(845) 210-1056
Taxonomy
Speciality
Code
Description
License number
State
146N00000X
Basic Emergency Medical Technician
Primary
138125
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
138152
NEW YORK STATE
NY
Enumeration date
07/21/2014
Last updated
07/21/2014
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