National Provider Identifier
Johnethen Travis Spicer
Johnethen Travis Spicer is listed in the NPPES registry with a primary specialty of Case Manager/Care Coordinator in Buffalo, NY and a listed phone number of (716) 856-2587.
Profile Overview
- NPI
- 1285461434
- Provider Type
- Individual
- Primary Specialty
- Case Manager/Care Coordinator
- Enumeration Date
- September 19, 2024
- Last Updated
- September 19, 2024
Practice Location
- 1050 Niagara St
- Buffalo, NY 14213-2001
Phone: (716) 856-2587
Specialties
- Case Manager/Care Coordinator (171M00000X)
Full Record
- NPI
- 1285461434
- Entity Type
- Individual
- Last Name
- Spicer
- First Name
- Johnethen
- Middle Name
- Travis
- Mailing Street Address
- 1050 Niagara St
- Mailing City
- Buffalo
- Mailing State
- NY
- Mailing ZIP Code
- 14213-2001
- Mailing Country
- US
- Practice Street Address
- 1050 Niagara St
- Practice City
- Buffalo
- Practice State
- NY
- Practice ZIP Code
- 14213-2001
- Practice Country
- US
- Practice Phone
- (716) 856-2587
- Enumeration Date
- September 19, 2024
- Last Updated
- September 19, 2024
- Sex
- Male
- Sole Proprietor
- No
- Certification Date
- September 19, 2024
- updated_by_file
- npidata_pfile_20050523-20260308.csv
- Taxonomies
- Case Manager/Care Coordinator (171M00000X)