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Individual

JEFFREY LANIER SPELL

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
PT, ATC

Contact information

Practice address
227 S PENDLETON ST, STE B, EASLEY, SC 29640-3047
(864) 855-7030
(864) 855-7019
Mailing address
227 S PENDLETON ST, STE B, EASLEY, SC 29640-3047
(864) 855-7030
(864) 855-7019

Taxonomy

Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
5178
SC
225100000X
Physical Therapist
PT 007458
GA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
726617849A
GA
Enumeration date
08/01/2006
Last updated
03/28/2011
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