MEDICARE: FLORENCE NEEDLE KOORIS 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
1	225X00000X	Occupational Therapist

General Provider Information

NPI Number	:	1184252413
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	FLORENCE NEEDLE KOORIS OTR/L

Provider Business Mailing Address
First Line	:	1589 SULLIVAN ST
Second Line	:
City	:	CHARLESTON
State	:	SC
Zip	:	29407-5020
Country	:	US
Telephone Number	:	803-260-1389
Fax Number	:

Provider Business Practice Location Address
First Line	:	1400 LIBERTY MIDTOWN DR
Second Line	:
City	:	MOUNT PLEASANT
State	:	SC
Zip	:	29464-3997
Country	:	US
Telephone Number	:	843-287-9556
Fax Number	:

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

Provider Enumeration Date	:	03/31/2020
Last Update Date	:	07/02/2024

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