Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225XG0600X | Occupational Therapist - Gerontology | 007575 | OH |
N | 225XP0019X | Occupational Therapist - Physical Rehabilitation | 007575 | OH |
NPI | 1174995757 |
---|---|
Provider Name | Mark Chapin JR. |
First Address | Wilton, CT 06897-4429 |
Second Address | Wilton, CT 06897-4429 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 22/10/2015 |
Last Update Date | 22/10/2015 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
007575 | OHIO OCCUPATIONAL THERAPY, PHYSICAL THERAPY, & ATHLETIC TRAINERS BOARD (OTPTAT) (01) | OH |