MEDICARE: MR. DAVID KAMUNYO MIRINGU OCCUPATION THERAPIST

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	12511	MA

General Provider Information

NPI Number	:	1235596396
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. DAVID KAMUNYO MIRINGU OCCUPATION THERAPIST

Provider Business Mailing Address
First Line	:	206 NORTH ROAD
Second Line	:
City	:	CHELMSFORD
State	:	MA
Zip	:	01824-4832
Country	:	US
Telephone Number	:	713-748-9128
Fax Number	:	978-319-9277

Provider Business Practice Location Address
First Line	:	206 NORTH ROAD
Second Line	:
City	:	CHELMSFORD
State	:	MA
Zip	:	01824-4832
Country	:	US
Telephone Number	:	713-748-9128
Fax Number	:	978-319-9277

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

Provider Enumeration Date	:	01/20/2016
Last Update Date	:	09/22/2020

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