Healthcare Provider Details

I. General information

NPI: 1285247122
Provider Name (Legal Business Name): WINSTON FOLKES JR. OTR
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/29/2020
Last Update Date: 08/29/2020
Certification Date: 08/29/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1125 FORREST AVE
DOVER DE
19904-3483
US

IV. Provider business mailing address

105 BUROOJY CT
E STROUDSBURG PA
18302-6843
US

V. Phone/Fax

Practice location:
  • Phone: 302-735-4900
  • Fax:
Mailing address:
  • Phone: 570-460-7157
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number
License Number StateDE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: