Provider Demographics
NPI:1417220948
Name:CRUTTENDEN, SPENCER JAMES (DC, CSCS)
Entity type:Individual
Prefix:DR
First Name:SPENCER
Middle Name:JAMES
Last Name:CRUTTENDEN
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Gender:M
Credentials:DC, CSCS
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Other - First Name:
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Mailing Address - Street 1:10049 MARTIS VALLEY RD
Mailing Address - Street 2:UNIT E
Mailing Address - City:TRUCKEE
Mailing Address - State:CA
Mailing Address - Zip Code:96161-0543
Mailing Address - Country:US
Mailing Address - Phone:530-582-0500
Mailing Address - Fax:530-582-0500
Practice Address - Street 1:10049 MARTIS VALLEY RD
Practice Address - Street 2:UNIT E
Practice Address - City:TRUCKEE
Practice Address - State:CA
Practice Address - Zip Code:96161-0543
Practice Address - Country:US
Practice Address - Phone:530-582-0500
Practice Address - Fax:530-582-0500
Is Sole Proprietor?:No
Enumeration Date:2012-02-14
Last Update Date:2017-09-28
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CA31591111N00000X, 111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor