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Individual

DR. SPENCER WILLIAM WADE

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
D.C.

Contact information

Practice address
565 W 465 N, SUITE 140, PROVIDENCE, UT 84332-4801
(433) 213-9645
(435) 213-9631
Mailing address
565 W 465 N, SUITE 140, PROVIDENCE, UT 84332-4801
(433) 213-9645
(435) 213-9631

Taxonomy

Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
8449495-1202
UT

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
8449495-1202
UTAH STATE DEPARTMENT OF COMMERCE
UT
Enumeration date
12/03/2010
Last updated
10/31/2013
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