Provider Demographics
NPI:1518722180
Name:SPANGLER, ZACHARY (PT, DPT)
Entity type:Individual
Prefix:
First Name:ZACHARY
Middle Name:
Last Name:SPANGLER
Suffix:
Gender:M
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:241 LAKEVIEW CT
Mailing Address - Street 2:
Mailing Address - City:BEAVERTON
Mailing Address - State:MI
Mailing Address - Zip Code:48612-8000
Mailing Address - Country:US
Mailing Address - Phone:989-488-8538
Mailing Address - Fax:
Practice Address - Street 1:2005 RIVER ST
Practice Address - Street 2:
Practice Address - City:SUSANVILLE
Practice Address - State:CA
Practice Address - Zip Code:96130-4524
Practice Address - Country:US
Practice Address - Phone:530-257-5341
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-02-13
Last Update Date:2024-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1385643225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist