Provider Demographics
NPI:1982974481
Name:SPRUILL, KARIN I (PT)
Entity type:Individual
Prefix:
First Name:KARIN
Middle Name:
Last Name:SPRUILL
Suffix:I
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8455 KINGTON WAY
Mailing Address - Street 2:
Mailing Address - City:CYPRESS
Mailing Address - State:CA
Mailing Address - Zip Code:90630-2341
Mailing Address - Country:US
Mailing Address - Phone:714-336-4151
Mailing Address - Fax:
Practice Address - Street 1:6850 LINCOLN AVE STE 104
Practice Address - Street 2:
Practice Address - City:BUENA PARK
Practice Address - State:CA
Practice Address - Zip Code:90620-4179
Practice Address - Country:US
Practice Address - Phone:714-699-1710
Practice Address - Fax:714-699-1712
Is Sole Proprietor?:Yes
Enumeration Date:2011-12-31
Last Update Date:2019-05-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA14715225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist