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NPI Code Detail

MEDICARE: MRS. HEATHER ELIZABETH KYSER OTR/L

MEDICARE: MRS. HEATHER ELIZABETH KYSER 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 Therapist2482AL

General Provider Information

NPI Number : 1306075494
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. HEATHER ELIZABETH KYSER OTR/L
Provider Business Mailing Address
First Line : 27141 COUNTY ROAD 38
Second Line :
City : OPP
State : AL
Zip : 36467-5801
Country : US
Telephone Number : 334-493-9960
Fax Number :
Provider Business Practice Location Address
First Line : 303 N HURSTBOURNE PKWY STE 200
Second Line :
City : LOUISVILLE
State : KY
Zip : 40222-5158
Country : US
Telephone Number : 502-412-5847
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/09/2009
Last Update Date : 12/03/2012

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