Individual
EILEEN BOLTZ SPANGLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DPT
Contact information
Practice address
213 GREENHILL AVE, STE C, WILMINGTON, DE 19805-1844
(302) 658-7800
(302) 658-1550
Mailing address
790 REMINGTON BLVD, BOLINGBROOK, IL 60440-4909
(630) 296-2223
(630) 759-3251
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
J10001871
DE
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
10000037584
—
DE
05
—
1000037584
—
DE
01
—
1477595999
CHAMPUS TRICARE
—
01
—
1730452
PABS
—
01
—
2398179000
AMERIHEALTH PROVIDER ID
PA
01
—
2398179000
AMERIHEALTH IBC
—
01
—
5070-0025
CARE FIRST
—
01
—
64249301
NCA
—
Enumeration date
06/11/2006
Last updated
12/23/2024
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