Provider Demographics
NPI:1366056046
Name:SAUNDERS, SPENCER
Entity type:Individual
Prefix:MR
First Name:SPENCER
Middle Name:
Last Name:SAUNDERS
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:230 JAYCEE CT APT 205
Mailing Address - Street 2:
Mailing Address - City:MANKATO
Mailing Address - State:MN
Mailing Address - Zip Code:56001-6949
Mailing Address - Country:US
Mailing Address - Phone:864-508-0891
Mailing Address - Fax:
Practice Address - Street 1:230 JAYCEE CT APT 205
Practice Address - Street 2:
Practice Address - City:MANKATO
Practice Address - State:MN
Practice Address - Zip Code:56001-6949
Practice Address - Country:US
Practice Address - Phone:864-508-0891
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-09-01
Last Update Date:2020-09-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program