Provider Demographics
NPI:1760627178
Name:MIHELCIC, EDWARD JOHN (PHD, OTR/L)
Entity Type:Individual
Prefix:MR
First Name:EDWARD
Middle Name:JOHN
Last Name:MIHELCIC
Suffix:
Gender:M
Credentials:PHD, OTR/L
Other - Prefix:
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Mailing Address - Street 1:640 KOLTER DR
Mailing Address - Street 2:
Mailing Address - City:INDIANA
Mailing Address - State:PA
Mailing Address - Zip Code:15701-3570
Mailing Address - Country:US
Mailing Address - Phone:724-357-7333
Mailing Address - Fax:724-835-7172
Practice Address - Street 1:25 COLONY BLVD STE 104
Practice Address - Street 2:
Practice Address - City:BLAIRSVILLE
Practice Address - State:PA
Practice Address - Zip Code:15717-7971
Practice Address - Country:US
Practice Address - Phone:247-459-1770
Practice Address - Fax:247-459-1780
Is Sole Proprietor?:No
Enumeration Date:2008-12-15
Last Update Date:2023-08-22
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
PAOC002483L225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist