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NPI Code Detail

MEDICARE: MR. TIMOTHY D SANDERS OTR/L

MEDICARE:  MR. TIMOTHY D SANDERS  OTR/L
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1225X00000XOccupational TherapistOT009558OH
2225X00000XOccupational Therapist6516AZ

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1TC832398OTHEROHDRIVER'S LICENSE

General Provider Information

NPI Number : 1225573660
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. TIMOTHY D SANDERS OTR/L
Provider Business Mailing Address
First Line : 430 E CLEVELAND ST
Second Line :
City : DELPHOS
State : OH
Zip : 45833-1903
Country : US
Telephone Number : 419-516-3096
Fax Number :
Provider Business Practice Location Address
First Line : 430 E CLEVELAND ST
Second Line :
City : DELPHOS
State : OH
Zip : 45833-1903
Country : US
Telephone Number : 419-516-3096
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/20/2016
Last Update Date : 12/20/2016

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Directions to “ MR. TIMOTHY D SANDERS OTR/L” Practice Location

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