Healthcare Provider Details

I. General information

NPI: 1861521429
Provider Name (Legal Business Name): ANDREW GARCHAR
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/02/2007
Last Update Date: 08/04/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7620 SOUTHERN BLVD SUITE 3
BOARDMAN OH
44512-5667
US

IV. Provider business mailing address

239 CLINGAN RD
STRUTHERS OH
44471-3105
US

V. Phone/Fax

Practice location:
  • Phone: 330-965-9330
  • Fax: 330-965-9308
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number4947
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: