Provider Demographics
NPI:1932158821
Name:MINNICK STAFFING SERVICES
Entity Type:Organization
Organization Name:MINNICK STAFFING SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:GREGG
Authorized Official - Middle Name:DAVID
Authorized Official - Last Name:MINNICK
Authorized Official - Suffix:
Authorized Official - Credentials:OTR/L
Authorized Official - Phone:724-962-2349
Mailing Address - Street 1:3404 HUMMINGBIRD LN
Mailing Address - Street 2:
Mailing Address - City:SHARPSVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:16150-8604
Mailing Address - Country:US
Mailing Address - Phone:724-962-2349
Mailing Address - Fax:
Practice Address - Street 1:3404 HUMMINGBIRD LN
Practice Address - Street 2:
Practice Address - City:SHARPSVILLE
Practice Address - State:PA
Practice Address - Zip Code:16150-8604
Practice Address - Country:US
Practice Address - Phone:724-962-2349
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-08
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOC004344L225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Multi-Specialty