Provider Demographics
NPI:1689289696
Name:MOTSINGER, LARRY A
Entity Type:Individual
Prefix:
First Name:LARRY
Middle Name:A
Last Name:MOTSINGER
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:883 S OHIO AVE
Mailing Address - Street 2:
Mailing Address - City:SIDNEY
Mailing Address - State:OH
Mailing Address - Zip Code:45365-3267
Mailing Address - Country:US
Mailing Address - Phone:937-638-2332
Mailing Address - Fax:
Practice Address - Street 1:873 CRESCENT DR APT 4
Practice Address - Street 2:
Practice Address - City:SIDNEY
Practice Address - State:OH
Practice Address - Zip Code:45365-3256
Practice Address - Country:US
Practice Address - Phone:937-492-1142
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-09-15
Last Update Date:2020-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes372500000XNursing Service Related ProvidersChore ProviderGroup - Single Specialty