Provider Demographics
NPI:1659402550
Name:ELANDER, CASSANDRA A (ATC)
Entity Type:Individual
Prefix:
First Name:CASSANDRA
Middle Name:A
Last Name:ELANDER
Suffix:
Gender:F
Credentials:ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5938 COMMONWEALTH DR
Mailing Address - Street 2:
Mailing Address - City:WESTERVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:43082-9325
Mailing Address - Country:US
Mailing Address - Phone:614-865-9066
Mailing Address - Fax:
Practice Address - Street 1:5938 COMMONWEALTH DR
Practice Address - Street 2:
Practice Address - City:WESTERVILLE
Practice Address - State:OH
Practice Address - Zip Code:43082-9325
Practice Address - Country:US
Practice Address - Phone:614-865-9066
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH0017102255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer