Provider Demographics
NPI:1679270789
Name:SPELLMAN, ELIZABETH (LICENSED ACUPUNCTURI)
Entity type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:
Last Name:SPELLMAN
Suffix:
Gender:F
Credentials:LICENSED ACUPUNCTURI
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:241 PAITSEL PL
Mailing Address - Street 2:
Mailing Address - City:NEW CASTLE
Mailing Address - State:VA
Mailing Address - Zip Code:24127-7802
Mailing Address - Country:US
Mailing Address - Phone:540-570-9218
Mailing Address - Fax:
Practice Address - Street 1:219 MAIN ST STE 3
Practice Address - Street 2:
Practice Address - City:NEW CASTLE
Practice Address - State:VA
Practice Address - Zip Code:24127-6349
Practice Address - Country:US
Practice Address - Phone:540-339-7538
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-02-09
Last Update Date:2023-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0121001003171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist