Most Relevant Information
Provider Data
| NPI Number: | 1003367392 |
| Provider Name: | MARY MAE SPRUILL |
| Entity Type: | Individual |
| Taxonomy Code: | 224Z00000X |
| Specialty: | Occupational Therapy Assistant |
| License Number: |
Most Important Dates
| Enumeration Date: | 10/20/2016 |
| Last Updated: | 10/20/2016 |
Provider Practice Location
12997 NETTLES DR
NEWPORT NEWS
VA
236026913
Practice Location Phone/Fax
| Phone: | 7572498880 |
| Fax: |
Provider Mailing Location
19040 WHITE OAK DR LOT 129
SMITHFIELD
VA
234306143
Provider Mailing Phone/Fax
| Phone: | |
| Fax: |