Healthcare Provider Details

I. General information

NPI: 1497094320
Provider Name (Legal Business Name): OCCUPATIONAL TESTING CONSULTANTS, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/13/2013
Last Update Date: 02/04/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

632 W STEIN HWY
SEAFORD DE
19973-1204
US

IV. Provider business mailing address

190 HAUT BRION AVE
NEWARK DE
19702-4540
US

V. Phone/Fax

Practice location:
  • Phone: 302-275-8670
  • Fax:
Mailing address:
  • Phone: 302-275-8670
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2083X0100X
TaxonomyOccupational Medicine Physician
License NumberC1-0004408
License Number StateDE
# 2
Primary TaxonomyY
Taxonomy Code2251E1200X
TaxonomyErgonomics Physical Therapist
License NumberJ1-0001437
License Number StateDE

VIII. Authorized Official

Name: DR. WILLIAM HOLLAND JR.
Title or Position: DIRECTOR
Credential: D.P.T.
Phone: 302-275-8670