Provider Demographics
NPI:1255022505
Name:JALBERT, SPENCER ROSE
Entity type:Individual
Prefix:
First Name:SPENCER
Middle Name:ROSE
Last Name:JALBERT
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:142 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:SALEM
Mailing Address - State:NH
Mailing Address - Zip Code:03079-3195
Mailing Address - Country:US
Mailing Address - Phone:603-894-4429
Mailing Address - Fax:
Practice Address - Street 1:142 MAIN ST
Practice Address - Street 2:
Practice Address - City:SALEM
Practice Address - State:NH
Practice Address - Zip Code:03079-3195
Practice Address - Country:US
Practice Address - Phone:603-894-4429
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-05-17
Last Update Date:2023-05-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183700000XPharmacy Service ProvidersPharmacy Technician