Provider Demographics
NPI:1144854399
Name:MCCRORY, SPENCER
Entity type:Individual
Prefix:
First Name:SPENCER
Middle Name:
Last Name:MCCRORY
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1811 BEECH CT
Mailing Address - Street 2:
Mailing Address - City:FREDERICK
Mailing Address - State:MD
Mailing Address - Zip Code:21701-9127
Mailing Address - Country:US
Mailing Address - Phone:240-440-4698
Mailing Address - Fax:
Practice Address - Street 1:1 COLLEGE AVE
Practice Address - Street 2:
Practice Address - City:MECHANICSBURG
Practice Address - State:PA
Practice Address - Zip Code:17055-6805
Practice Address - Country:US
Practice Address - Phone:240-440-4698
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-02-26
Last Update Date:2020-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer