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NPI Code Detail

MEDICARE: ERIN COLLEY OTR/L

MEDICARE: ERIN COLLEY OTR/L
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
1225X00000XOccupational TherapistOT.006108OH

General Provider Information

NPI Number : 1033457700
Entity Type Code : Individual
Provider Name (Legal Business Name) : ERIN COLLEY OTR/L
Provider Business Mailing Address
First Line : 529 RASES MOUNTAIN DR
Second Line :
City : MINFORD
State : OH
Zip : 45653-8622
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 10098 BEAR CREEK RD
Second Line :
City : LUCASVILLE
State : OH
Zip : 45648-9168
Country : US
Telephone Number : 740-259-5536
Fax Number : 740-259-4259
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/30/2013
Last Update Date : 01/30/2013

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