Individual
DR. DALE R. SPENCER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
704 N STATE ST, UKIAH, CA 95482-3408
(707) 462-2602
Mailing address
704 N STATE ST, UKIAH, CA 95482-3408
(707) 462-2602
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
5466T
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
SD0054660
—
CA
Enumeration date
03/28/2006
Last updated
07/08/2007
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