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NPI Code Detail

MEDICARE: DERRICK A. TOWNSEND O.T.

MEDICARE: DERRICK A. TOWNSEND O.T.
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 TherapistOTT.200258LA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1OTT.200258OTHERLASTATE LICENSE

General Provider Information

NPI Number : 1366699316
Entity Type Code : Individual
Provider Name (Legal Business Name) : DERRICK A. TOWNSEND O.T.
Provider Business Mailing Address
First Line : 2346 S RANGE AVE
Second Line :
City : DENHAM SPRINGS
State : LA
Zip : 70726-5216
Country : US
Telephone Number : 225-665-8080
Fax Number : 225-665-0999
Provider Business Practice Location Address
First Line : 2346 S RANGE AVE
Second Line :
City : DENHAM SPRINGS
State : LA
Zip : 70726-5216
Country : US
Telephone Number : 225-665-8080
Fax Number : 225-665-0999
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/21/2008
Last Update Date : 08/21/2008

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Directions to “ DERRICK A. TOWNSEND O.T.” Practice Location

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