Provider Demographics
NPI:1962786202
Name:SPIKER, ANSLEY MARIE (PTA)
Entity type:Individual
Prefix:MS
First Name:ANSLEY
Middle Name:MARIE
Last Name:SPIKER
Suffix:
Gender:F
Credentials:PTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2600 E SPRINGFIELD PL UNIT 65
Mailing Address - Street 2:
Mailing Address - City:CHANDLER
Mailing Address - State:AZ
Mailing Address - Zip Code:85286-1448
Mailing Address - Country:US
Mailing Address - Phone:480-414-8392
Mailing Address - Fax:
Practice Address - Street 1:5358 E BASELINE RD
Practice Address - Street 2:
Practice Address - City:MESA
Practice Address - State:AZ
Practice Address - Zip Code:85206-4716
Practice Address - Country:US
Practice Address - Phone:480-699-9624
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-10-05
Last Update Date:2011-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ8736A225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant