Provider Demographics
NPI:1831239326
Name:SPRADLIN, JEFFREY LEE (OTR)
Entity type:Individual
Prefix:
First Name:JEFFREY
Middle Name:LEE
Last Name:SPRADLIN
Suffix:
Gender:M
Credentials:OTR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7038 WYNDHAM POINTE LANE
Mailing Address - Street 2:
Mailing Address - City:KNOXVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37931
Mailing Address - Country:US
Mailing Address - Phone:865-803-4244
Mailing Address - Fax:888-597-4365
Practice Address - Street 1:605 N MAIN ST
Practice Address - Street 2:
Practice Address - City:ONEIDA
Practice Address - State:TN
Practice Address - Zip Code:37841-2517
Practice Address - Country:US
Practice Address - Phone:423-569-1600
Practice Address - Fax:423-569-1583
Is Sole Proprietor?:No
Enumeration Date:2007-02-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN1099225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist