Provider Demographics
NPI:1336376334
Name:ISAACSON, CHAD (OTR/L)
Entity Type:Individual
Prefix:
First Name:CHAD
Middle Name:
Last Name:ISAACSON
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 1:244 N MINDEN AVE
Mailing Address - Street 2:
Mailing Address - City:MINDEN
Mailing Address - State:NE
Mailing Address - Zip Code:68959-1643
Mailing Address - Country:US
Mailing Address - Phone:308-832-1500
Mailing Address - Fax:308-832-1551
Practice Address - Street 1:244 N MINDEN AVE
Practice Address - Street 2:
Practice Address - City:MINDEN
Practice Address - State:NE
Practice Address - Zip Code:68959-1643
Practice Address - Country:US
Practice Address - Phone:308-832-1500
Practice Address - Fax:308-832-1551
Is Sole Proprietor?:No
Enumeration Date:2009-06-17
Last Update Date:2022-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE882225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE882OtherSTATE LICENSE NUMBER