Provider Demographics
NPI:1538584958
Name:SPRING, ALIRA N (PA-C)
Entity type:Individual
Prefix:
First Name:ALIRA
Middle Name:N
Last Name:SPRING
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:ALIRA
Other - Middle Name:N
Other - Last Name:CARPENTER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:801 YORK ST
Mailing Address - Street 2:
Mailing Address - City:MANITOWOC
Mailing Address - State:WI
Mailing Address - Zip Code:54220-4630
Mailing Address - Country:US
Mailing Address - Phone:920-663-9008
Mailing Address - Fax:920-684-1439
Practice Address - Street 1:1821 SOUTH AVE W STE 402
Practice Address - Street 2:
Practice Address - City:MISSOULA
Practice Address - State:MT
Practice Address - Zip Code:59801-6518
Practice Address - Country:US
Practice Address - Phone:406-543-8512
Practice Address - Fax:406-541-8513
Is Sole Proprietor?:No
Enumeration Date:2014-02-21
Last Update Date:2023-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MTMED-PAC-LIC-300061363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
Provider Identifiers
StateIdentifier IDID TypeIssuer
MTM011004295OtherMEDICARE ID