Healthcare Provider Details

I. General information

NPI: 1720446552
Provider Name (Legal Business Name): STEVEN WHEELER PH.D., OTR/L
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/08/2016
Last Update Date: 02/08/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2150 CARTER AVE
ASHLAND KY
41101-7734
US

IV. Provider business mailing address

3209 LEMLEY ST
MORGANTOWN WV
26508-9188
US

V. Phone/Fax

Practice location:
  • Phone: 606-325-1338
  • Fax:
Mailing address:
  • Phone: 304-293-8725
  • Fax: 304-293-7105

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225XN1300X
TaxonomyNeurorehabilitation Occupational Therapist
License NumberR2613
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: