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DR. ILENE M. SPECTOR D.O.
>> Neuromusculoskeletal Medicine & OMM >> Allopathic & Osteopathic PhysiciansRegistrant NPI Number: 1477643799
Individual Registrant:DR. ILENE M. SPECTOR D.O.
Gender: F
Sole Proprietor
Gender: F
Sole Proprietor
Location and contact information for practice:
277A BLACKSTOCK DR. CRESTED BUTTE, CO 81224 US
Tel: 970-349-2095 Fax: 970-349-2095
Tel: 970-349-2095 Fax: 970-349-2095
Contact information for business:
277A BLACKSTOCK DR. CRESTED BUTTE, CO 81224 US
Tel: 970-349-2095 Fax: 970-349-2095
Tel: 970-349-2095 Fax: 970-349-2095
Registration Information:
NPI: 1477643799
Entity Type: Individual
Entity Type: Individual
Specialty information:
| Primary | Code | Category/Description | State | License Number |
|---|---|---|---|---|
| Y | 204D00000X | Allopathic & Osteopathic Physicians Neuromusculoskeletal Medicine & OMM | CO | 41577 |
| N | 204D00000X | Allopathic & Osteopathic Physicians Neuromusculoskeletal Medicine & OMM | AZ | 2588 |
| N | 208D00000X | Allopathic & Osteopathic Physicians General Practice | CO | 41577 |
| N | 208D00000X | Allopathic & Osteopathic Physicians General Practice | AZ | 2588 |
Legacy codes, insurance codes and state license numbers:
| Issuer | Number | State | Type |
|---|---|---|---|
