Doctor Name: | EDGAR W WORRELL |
NPI Number: | 1528138138 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | OTR |
License Number: | OT 002151 |
Business Practice Address: | 4293 Pond View Ct Bellbrook, OH - 453051494 |
Business Phone Number: | 9378484803 |
Business Fax Number: | |
Mailing Address: | 4293 Pond View Ct, BELLBROOK |
State: | OH |
Postal Code: | 453051494 |
Phone Number: | 9378484803 |
Fax Number: | 9378484803 |
NPI Enumeration Date: | 11/09/2006 |
NPI Last Update Date: | 08/26/2008 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 225000000X |
License Number: | OT 002151 |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | OH |
Taxonomy Type: | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
Taxonomy Classification: | Orthotic Fitter |
Taxonomy Specialization: | |
Taxonomy Definition: | An individual trained in the management of fitting prefabricated orthoses. |