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NPI Code Detail

MEDICARE: WILLIAM EBERSOLE OTR/L

MEDICARE: WILLIAM EBERSOLE 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 TherapistOT.010305OH

General Provider Information

NPI Number : 1396213427
Entity Type Code : Individual
Provider Name (Legal Business Name) : WILLIAM EBERSOLE OTR/L
Provider Business Mailing Address
First Line : 2108 LANDER RD
Second Line :
City : MAYFIELD HEIGHTS
State : OH
Zip : 44124-4137
Country : US
Telephone Number : 440-813-4236
Fax Number : 440-443-0767
Provider Business Practice Location Address
First Line : 2108 LANDER RD
Second Line :
City : MAYFIELD HEIGHTS
State : OH
Zip : 44124-4137
Country : US
Telephone Number : 440-443-0345
Fax Number : 440-443-0767
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/07/2018
Last Update Date : 11/07/2018

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Directions to “ WILLIAM EBERSOLE OTR/L” Practice Location

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