Provider Demographics
NPI:1144970187
Name:WESTRICK, CASSANDRA MARIE
Entity type:Individual
Prefix:
First Name:CASSANDRA
Middle Name:MARIE
Last Name:WESTRICK
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:143 S EASTOM ST
Mailing Address - Street 2:
Mailing Address - City:LEIPSIC
Mailing Address - State:OH
Mailing Address - Zip Code:45856-1270
Mailing Address - Country:US
Mailing Address - Phone:419-889-7112
Mailing Address - Fax:
Practice Address - Street 1:304 HILTON DR
Practice Address - Street 2:
Practice Address - City:PANDORA
Practice Address - State:OH
Practice Address - Zip Code:45877
Practice Address - Country:US
Practice Address - Phone:887-787-3430
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-03-24
Last Update Date:2022-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHPTA013105225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant