Healthcare Provider Details

I. General information

NPI: 1871637181
Provider Name (Legal Business Name): WILLIAM TIMOTHY SESCO DC
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/19/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1527 LEXINGTON AVE
MANSFIELD OH
44907-2631
US

IV. Provider business mailing address

1527 LEXINGTON AVE
MANSFIELD OH
44907-2631
US

V. Phone/Fax

Practice location:
  • Phone: 419-524-3030
  • Fax: 419-756-1142
Mailing address:
  • Phone: 419-524-3030
  • Fax: 419-756-1142

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number3332
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: