Individual provider · NPI-1
Seth Bidlack, OT
Occupational Therapist, Physical Rehabilitation · Cecil, OH
NPI number1780215657
StatusActive
Last updated in NPPESDec 18, 2024
Details
- NPI
- 1780215657
- Entity type
- Individual (NPI-1)
- Name
- Seth Bidlack
- Credential
- OT
- Sex
- Male
- Sole proprietor
- No
- Enumeration date
- Jan 30, 2020
- Certification date
- Dec 18, 2024
- Last updated
- Dec 18, 2024
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 225XP0019X | Occupational Therapist, Physical Rehabilitation | OT011233 | OH | Yes |
| 2255A2300X | Specialist/Technologist, Athletic Trainer | AT003966 | OH | |
| 225XP0019X | Occupational Therapist, Physical Rehabilitation | 31007078A | IN |
Practice location
11154 Road 230Cecil, OH 45821-9309
Phone 419-438-5026
Mailing address
11154 Road 230Cecil, OH 45821-9309
Phone 419-438-5026
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