Provider Demographics
NPI:1144734377
Name:SPRY, DENNIS VIRGIL (PCA)
Entity type:Individual
Prefix:MR
First Name:DENNIS
Middle Name:VIRGIL
Last Name:SPRY
Suffix:
Gender:M
Credentials:PCA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:212 HILLTOP DRIVE
Mailing Address - Street 2:
Mailing Address - City:LEWISBURG
Mailing Address - State:WV
Mailing Address - Zip Code:24901
Mailing Address - Country:US
Mailing Address - Phone:304-645-1807
Mailing Address - Fax:
Practice Address - Street 1:212 HILLTOP DRIVE
Practice Address - Street 2:
Practice Address - City:LEWISBURG
Practice Address - State:WV
Practice Address - Zip Code:24901-8911
Practice Address - Country:US
Practice Address - Phone:304-645-1807
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-11-27
Last Update Date:2017-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant