Provider Demographics
NPI:1992148308
Name:SPENCE, CHELSEY LYNNE (DO)
Entity type:Individual
Prefix:
First Name:CHELSEY
Middle Name:LYNNE
Last Name:SPENCE
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:306 STONER LOOP RD
Mailing Address - Street 2:
Mailing Address - City:LAKESIDE
Mailing Address - State:MT
Mailing Address - Zip Code:59922-9539
Mailing Address - Country:US
Mailing Address - Phone:406-844-0541
Mailing Address - Fax:
Practice Address - Street 1:306 STONER LOOP RD
Practice Address - Street 2:
Practice Address - City:LAKESIDE
Practice Address - State:MT
Practice Address - Zip Code:59922-9539
Practice Address - Country:US
Practice Address - Phone:406-844-0541
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-04-16
Last Update Date:2023-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
MT49537207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program