Provider Demographics
NPI:1164877585
Name:SPELL, CHRISTANNE (LAC)
Entity type:Individual
Prefix:
First Name:CHRISTANNE
Middle Name:
Last Name:SPELL
Suffix:
Gender:F
Credentials:LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7053 LEE HWY STE 305
Mailing Address - Street 2:
Mailing Address - City:CHATTANOOGA
Mailing Address - State:TN
Mailing Address - Zip Code:37421-1823
Mailing Address - Country:US
Mailing Address - Phone:423-521-0480
Mailing Address - Fax:
Practice Address - Street 1:7053 LEE HWY STE 305
Practice Address - Street 2:
Practice Address - City:CHATTANOOGA
Practice Address - State:TN
Practice Address - Zip Code:37421-1823
Practice Address - Country:US
Practice Address - Phone:423-521-0480
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-05-04
Last Update Date:2024-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAC01681171100000X
TXAC01619171100000X
TNACU0000000532171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist