Provider Demographics
NPI:1538435177
Name:SPALE, DAWN ALICIA (DC)
Entity type:Individual
Prefix:
First Name:DAWN
Middle Name:ALICIA
Last Name:SPALE
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:825 FREEPORT RD
Mailing Address - Street 2:
Mailing Address - City:BRACKENRIDGE
Mailing Address - State:PA
Mailing Address - Zip Code:15014-1085
Mailing Address - Country:US
Mailing Address - Phone:724-224-2224
Mailing Address - Fax:724-226-3988
Practice Address - Street 1:825 FREEPORT RD
Practice Address - Street 2:
Practice Address - City:BRACKENRIDGE
Practice Address - State:PA
Practice Address - Zip Code:15014-1085
Practice Address - Country:US
Practice Address - Phone:724-224-2224
Practice Address - Fax:724-226-3988
Is Sole Proprietor?:No
Enumeration Date:2012-03-28
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADC010575111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1032406300001Medicaid