Individual
MS. STACI CARROL SPRAUER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
405 CINDY LN, MOUNT ANGEL, OR 97362-9592
(541) 948-2362
Mailing address
405 CINDY LN, MOUNT ANGEL, OR 97362-9592
(541) 948-2362
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
19370
OR
Other
Enumeration date
11/19/2012
Last updated
11/19/2012
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