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Individual

PAIGE SPEAR

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
661 US 31W BYP STE C, BOWLING GREEN, KY 42101
(270) 779-9727
Mailing address
661 US 31W BYP STE C, BOWLING GREEN, KY 42101-4968

Taxonomy

Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
KY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
06-44-1501079
TATTOO ARTIST CERTIFICATE
KY
01
FB971385
PARAMEDICAL SPECIALIST
GA
Enumeration date
08/21/2018
Last updated
08/21/2018
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