Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225XH1200X | Occupational Therapist - Hand | 13772 | FL |
NPI | 1265420285 |
---|---|
Provider Name | Michelle Ann Greer |
First Address | Bradenton, FL 34209-5525 |
Second Address | Bradenton, FL 34209-5525 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 13/10/2005 |
Last Update Date | 24/01/2014 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
Z02KR | BCBS (01) | FL |