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NPI Code Detail

MEDICARE: AMBER J MICHAEL OTR/L

MEDICARE:   AMBER J MICHAEL  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 Therapist084366IA
2225X00000XOccupational Therapist105258MN

General Provider Information

NPI Number : 1265944318
Entity Type Code : Individual
Provider Name (Legal Business Name) : AMBER J MICHAEL OTR/L
Provider Business Mailing Address
First Line : 1415 OAK BEACH DR
Second Line :
City : FAIRMONT
State : MN
Zip : 56031-3108
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 610 SUMMIT DR
Second Line :
City : FAIRMONT
State : MN
Zip : 56031-2247
Country : US
Telephone Number : 507-235-6606
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/30/2017
Last Update Date : 03/17/2018

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Directions to “ AMBER J MICHAEL OTR/L” Practice Location

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