Basic Information
| Provider Information | |||||||||
| NPI: | 1174897136 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | SPILLANE | ||||||||
| FirstName: | JOHN | ||||||||
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| Credential: | OTR | ||||||||
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| Mailing Information | |||||||||
| Address1: | 906 LAKEVIEW AVE | ||||||||
| Address2: | |||||||||
| City: | MILFORD | ||||||||
| State: | DE | ||||||||
| PostalCode: | 199631732 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3024221600 | ||||||||
| FaxNumber: | 3026848931 | ||||||||
| Practice Location | |||||||||
| Address1: | 906 LAKEVIEW AVE | ||||||||
| Address2: | |||||||||
| City: | MILFORD | ||||||||
| State: | DE | ||||||||
| PostalCode: | 199631732 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3026844950 | ||||||||
| FaxNumber: | 3026848931 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 03/08/2012 | ||||||||
| LastUpdateDate: | 03/08/2012 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 225X00000X | U1-0001003 | DE | Y | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Occupational Therapist |
No ID Information.