Individual
CHARLES SPENCER III
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
ATC, EMT
Contact information
Practice address
125 BURNHAM RD, SCARBOROUGH, ME 04074-9156
(207) 730-3002
Mailing address
125 BURNHAM RD, SCARBOROUGH, ME 04074-9156
(207) 730-3002
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
AT520
ME
Other
Enumeration date
06/18/2014
Last updated
06/18/2014
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