Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 225X00000X | Occupational Therapist | 1702906 | KS |
Y | 225XN1300X | Occupational Therapist - Neurorehabilitation | 31006136A | IN |
NPI | 1407284607 |
---|---|
Provider Name | Hiram Tame |
First Address | Columbus, IN 47203-2970 |
Second Address | Columbus, IN 47203-2970 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 24/10/2013 |
Last Update Date | 11/11/2021 |