Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225XH1200X | Occupational Therapist - Hand | OT2114 | OH |
NPI | 1174664700 |
---|---|
Provider Name | Julie Carpenter |
First Address | Strongsville, OH 44136-3353 |
Second Address | Strongsville, OH 44136-3353 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 08/02/2007 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
PO0322765 | MEDICARE - RAILROAD (01) | OH |