MEDICARE: AMANDA TERSTRIEP OT

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	225X00000X	Occupational Therapist	056008002	IL

General Provider Information

NPI Number	:	1023135647
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	AMANDA TERSTRIEP OT

Provider Business Mailing Address
First Line	:	409 GRAND AVE
Second Line	:
City	:	WATERLOO
State	:	IL
Zip	:	62298-1110
Country	:	US
Telephone Number	:	217-316-2419
Fax Number	:	888-452-2930

Provider Business Practice Location Address
First Line	:	634 N MAIN ST
Second Line	:	SUITE 5
City	:	O FALLON
State	:	IL
Zip	:	62269-3746
Country	:	US
Telephone Number	:	618-690-0068
Fax Number	:	888-452-2930

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/26/2007
Last Update Date	:	11/25/2025

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