Individual
MRS. JEANINE LERAE SPANO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
810 S 6TH ST, LAMAR, CO 81052-3111
(719) 688-9366
Mailing address
810 S 6TH ST, LAMAR, CO 81052-3111
(719) 688-9366
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
14-01958
KS
Other
Enumeration date
10/07/2008
Last updated
04/08/2011
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