MEDICARE: QUEST PEDIATRIC THERAPY

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	225XP0200X	Pediatric Occupational Therapist	1527	OK

General Provider Information

NPI Number	:	1417335225
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	QUEST PEDIATRIC THERAPY

Provider Business Mailing Address
First Line	:	PO BOX 892373
Second Line	:
City	:	OKLAHOMA CITY
State	:	OK
Zip	:	73189-2373
Country	:	US
Telephone Number	:	405-650-5863
Fax Number	:

Provider Business Practice Location Address
First Line	:	607 N WESTERN AVE
Second Line	:
City	:	OKLAHOMA CITY
State	:	OK
Zip	:	73106-7413
Country	:	US
Telephone Number	:	405-650-5863
Fax Number	:

Authorized Official
Title or Position	:	CO-OWNER/OCCUPATIONAL THERAPIST
Name	:	ELIZABETH ANN HYLTON
Credential	:	MOT, OTR/L
Telephone Number	:	405-650-5863

Provider Enumeration Date	:	05/12/2015
Last Update Date	:	05/21/2015

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