MEDICARE: WEST THERAPY LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225XP0200X	Pediatric Occupational Therapist	5201006325	MI

General Provider Information

NPI Number	:	1003198193
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	WEST THERAPY LLC

Provider Business Mailing Address
First Line	:	2446 MANCHESTER RD
Second Line	:
City	:	BIRMINGHAM
State	:	MI
Zip	:	48009-5894
Country	:	US
Telephone Number	:	586-201-5119
Fax Number	:

Provider Business Practice Location Address
First Line	:	2446 MANCHESTER RD
Second Line	:
City	:	BIRMINGHAM
State	:	MI
Zip	:	48009-5894
Country	:	US
Telephone Number	:	586-201-5119
Fax Number	:

Authorized Official
Title or Position	:	OTR/L
Name	:	MRS. MEGAN LYNN WEST
Credential	:
Telephone Number	:	586-201-5119

Provider Enumeration Date	:	09/14/2011
Last Update Date	:	09/14/2011

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Directions to “WEST THERAPY LLC ” Practice Location

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