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Individual

ERIC SPEARS

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man

Contact information

Practice address
840 N FERDON BLVD, CRESTVIEW, FL 32536-2157
(850) 682-5354
(850) 682-5354
Mailing address
840 N FERDON BLVD, CRESTVIEW, FL 32536-2157
(850) 682-5354
(850) 682-5354

Taxonomy

Speciality
Code
Description
License number
State
171W00000X
Contractor
Primary
JB133879
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
691206100
FL
Enumeration date
03/12/2014
Last updated
03/12/2014
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