Provider Demographics
NPI:1578663464
Name:BAINHAUER, MICHAEL W (OTR/L)
Entity Type:Individual
Prefix:
First Name:MICHAEL
Middle Name:W
Last Name:BAINHAUER
Suffix:
Gender:M
Credentials:OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:373 COLONIAL CREST DR
Mailing Address - Street 2:
Mailing Address - City:LANCASTER
Mailing Address - State:PA
Mailing Address - Zip Code:17601-6130
Mailing Address - Country:US
Mailing Address - Phone:813-215-5780
Mailing Address - Fax:
Practice Address - Street 1:1020 NEW HOLLAND AVE
Practice Address - Street 2:
Practice Address - City:LANCASTER
Practice Address - State:PA
Practice Address - Zip Code:17601-5606
Practice Address - Country:US
Practice Address - Phone:717-606-1653
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-09-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOT 10752225XP0200X
PAOC006308L225XP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics