Healthcare Provider Details

I. General information

NPI: 1720898968
Provider Name (Legal Business Name): CASSANDRA THATCHER CPO
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/09/2025
Last Update Date: 01/09/2025
Certification Date: 01/09/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

514 N DUPONT HWY
DOVER DE
19901-3961
US

IV. Provider business mailing address

129 PEACH BLOSSOM LN
CAMDEN WYOMING DE
19934-1975
US

V. Phone/Fax

Practice location:
  • Phone: 302-677-0693
  • Fax:
Mailing address:
  • Phone: 315-863-0662
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code222Z00000X
TaxonomyOrthotist
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code224P00000X
TaxonomyProsthetist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: