MEDICARE: STEPHANIE HUNT 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
1	174400000X	Specialist	1614	OK

General Provider Information

NPI Number	:	1417189721
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	STEPHANIE HUNT OTR/L

Provider Business Mailing Address
First Line	:	4120 N PORTLAND AVE
Second Line	:
City	:	OKLAHOMA CITY
State	:	OK
Zip	:	73112-6311
Country	:	US
Telephone Number	:	405-605-1466
Fax Number	:	405-605-1467

Provider Business Practice Location Address
First Line	:	4120 N PORTLAND AVE
Second Line	:
City	:	OKLAHOMA CITY
State	:	OK
Zip	:	73112-6311
Country	:	US
Telephone Number	:	405-605-1466
Fax Number	:	405-605-1467

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

Provider Enumeration Date	:	08/20/2009
Last Update Date	:	08/20/2009

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