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NPI Code Detail

MEDICARE: MRS. JENNIFER HELEN POPHAM OTR

MEDICARE:  MRS. JENNIFER HELEN POPHAM  OTR
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 Therapist3243NC

General Provider Information

NPI Number : 1215074406
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. JENNIFER HELEN POPHAM OTR
Provider Business Mailing Address
First Line : 304 JUDD PLACE DR
Second Line :
City : FUQUAY VARINA
State : NC
Zip : 27526-2386
Country : US
Telephone Number : 919-557-8305
Fax Number : 919-557-8306
Provider Business Practice Location Address
First Line : 304 JUDD PLACE DR
Second Line :
City : FUQUAY VARINA
State : NC
Zip : 27526-2386
Country : US
Telephone Number : 919-557-8305
Fax Number : 919-557-8306
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/30/2007
Last Update Date : 09/24/2014

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Directions to “ MRS. JENNIFER HELEN POPHAM OTR” Practice Location

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