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KIMYUATTA A SPENCER RPT

>> Home Health >> Agencies

Registrant NPI Number: 1760600308

Individual Registrant:
 KIMYUATTA A SPENCER RPT
Gender: F
Sole Proprietor

Location and contact information for practice:
216 1ST ST S  REFORM, AL 35481 US
Tel: 205-375-9255  Fax: 205-375-9245

Contact information for business:
11118 ALFORD AVE  NORTHPORT, AL 35475-4530 US
Tel: 205-330-8526  Fax: --

Registration Information:
NPI: 1760600308
Entity Type: Individual

Specialty information:

PrimaryCodeCategory/DescriptionStateLicense Number
Y251E00000XAgencies
Home Health
ALPTH3586

Legacy codes, insurance codes and state license numbers:

IssuerNumberStateType
BCBS PROVIDER NUMBER51532337AL01
LICENSURE NUMBERPTH3586AL01




HEALTH CARE JOBS AL - Page 1



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