Provider Demographics
NPI:1780802587
Name:FOLTS, DAVID J
Entity type:Individual
Prefix:
First Name:DAVID
Middle Name:J
Last Name:FOLTS
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 1:1466 MARLANE DR
Mailing Address - Street 2:
Mailing Address - City:GIRARD
Mailing Address - State:OH
Mailing Address - Zip Code:44420-1466
Mailing Address - Country:US
Mailing Address - Phone:330-539-0753
Mailing Address - Fax:
Practice Address - Street 1:1325 CHURCHILL HUBBARD RD
Practice Address - Street 2:
Practice Address - City:YOUNGSTOWN
Practice Address - State:OH
Practice Address - Zip Code:44505-1346
Practice Address - Country:US
Practice Address - Phone:330-759-5904
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-04-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH1747225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist