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NPI Code Detail

MEDICARE: CAROL RETAMOZO

MEDICARE: CAROL RETAMOZO
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 Therapist

General Provider Information

NPI Number : 1104927045
Entity Type Code : Individual
Provider Name (Legal Business Name) : CAROL RETAMOZO
Provider Business Mailing Address
First Line : 2824 JASMINE CT NE
Second Line :
City : ATLANTA
State : GA
Zip : 30345-1432
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 4641 ROSWELL RD
Second Line :
City : ATLANTA
State : GA
Zip : 30342-3073
Country : US
Telephone Number : 404-474-0506
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/25/2006
Last Update Date : 08/24/2015

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Directions to “ CAROL RETAMOZO ” Practice Location

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