Individual
BRENT ALLEN CADWALLADER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
COTA
Contact information
Practice address
5900 MEADOW CREEK DR, MILFORD, OH 45150-5641
(513) 248-7207
Mailing address
67 MARY ST, PEEBLES, OH 45660-1147
(937) 587-0176
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
OTA.01998
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0616533
—
OH
Enumeration date
06/28/2007
Last updated
07/08/2007
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