Blackie, Spencer David

Blackie, Spencer David is an individual health care provider with primary practice located at 1505 Orrin Rd , Prescott WI 54021-1074. He recently has 2 registered licenses in different health care specialties including Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Physical Therapist, Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Occupational Therapist. Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Physical Therapist is his primary health care specialty. Blackie, Spencer David can be contacted via phone (715) 262-1107.

Contact Information

Primary practice address
1505 Orrin Rd Prescott WI 54021-1074
Phone: (715) 262-1107
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Physical Therapist 225100000X 4300-24 Wisconsin
Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Occupational Therapist 225X00000X 1811-26 Wisconsin

Profile Details

NPI number 1083982565
LBN Legal business name Blackie, Spencer David
Credentials PT, DPT, MA, OTR,
Entity Individual
Sole proprietor 1 No
Enumeration date Dec 12th, 2011
Last updated Dec 12th, 2011 - about 15 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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