Provider Demographics
NPI:1811951254
Name:VANHULTEN, RANDY (OTR)
Entity type:Individual
Prefix:
First Name:RANDY
Middle Name:
Last Name:VANHULTEN
Suffix:
Gender:M
Credentials:OTR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1440 PERRI DR
Mailing Address - Street 2:
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15226-2519
Mailing Address - Country:US
Mailing Address - Phone:412-680-0058
Mailing Address - Fax:
Practice Address - Street 1:969 GREENTREE ROAD
Practice Address - Street 2:SUITE 170
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15220-3328
Practice Address - Country:US
Practice Address - Phone:412-922-3344
Practice Address - Fax:412-922-8488
Is Sole Proprietor?:No
Enumeration Date:2006-04-13
Last Update Date:2023-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOC003939-L225X00000X
PAOC003939L225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist