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NPI Code Detail

MEDICARE: TAMARA MARIE SLANKARD OT

MEDICARE: TAMARA MARIE SLANKARD OT
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 Therapist056-003204IL

General Provider Information

NPI Number : 1457301947
Entity Type Code : Individual
Provider Name (Legal Business Name) : TAMARA MARIE SLANKARD OT
Provider Business Mailing Address
First Line : 5569 N SUGAR CREEK RD
Second Line :
City : OLNEY
State : IL
Zip : 62450-4047
Country : US
Telephone Number : 618-395-6041
Fax Number : 618-395-6289
Provider Business Practice Location Address
First Line : 800 E LOCUST ST
Second Line : RICHLAND MEMORIAL HOSPITAL
City : OLNEY
State : IL
Zip : 62450-2553
Country : US
Telephone Number : 618-395-6041
Fax Number : 618-395-6289
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/12/2006
Last Update Date : 08/12/2009

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