Provider Demographics
NPI:1609624485
Name:SADLER, JOEL
Entity type:Individual
Prefix:
First Name:JOEL
Middle Name:
Last Name:SADLER
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 1:1593 SUMMIT RD#1
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45237
Mailing Address - Country:US
Mailing Address - Phone:502-593-4694
Mailing Address - Fax:
Practice Address - Street 1:1593 SUMMIT RD#1
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45237
Practice Address - Country:US
Practice Address - Phone:502-593-4694
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-05-08
Last Update Date:2024-05-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHRS962289172A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172A00000XOther Service ProvidersDriver