Provider Demographics
NPI:1902590151
Name:BIDDLE, AUSTIN J
Entity Type:Individual
Prefix:
First Name:AUSTIN
Middle Name:J
Last Name:BIDDLE
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 1:428 SHREWSBURY ST
Mailing Address - Street 2:
Mailing Address - City:HOLLAND
Mailing Address - State:OH
Mailing Address - Zip Code:43528-8568
Mailing Address - Country:US
Mailing Address - Phone:567-239-6492
Mailing Address - Fax:
Practice Address - Street 1:428 SHREWSBURY ST
Practice Address - Street 2:
Practice Address - City:HOLLAND
Practice Address - State:OH
Practice Address - Zip Code:43528-8568
Practice Address - Country:US
Practice Address - Phone:567-239-6492
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-06-08
Last Update Date:2023-06-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHSA025308344600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes344600000XTransportation ServicesTaxi