MEDICARE: KRISTINE Y MILLIRON OTR/L, CHT

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	225X00000X	Occupational Therapist	0710	AL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	51509133	OTHER	AL	BCBS
2	51517655	OTHER	AL	BCBS
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
4	51502523	OTHER	AL	BCBS
5	1003819608	OTHER	AL	GROUP NPI

General Provider Information

NPI Number	:	1528002284
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KRISTINE Y MILLIRON OTR/L, CHT

Provider Business Mailing Address
First Line	:	251 JOHNSTON ST SUITE 300
Second Line	:
City	:	DECATUR
State	:	AL
Zip	:	35601-2515
Country	:	US
Telephone Number	:	256-340-9708
Fax Number	:	256-340-9624

Provider Business Practice Location Address
First Line	:	2801 JOHN HAWKINS PKWY STE 141K
Second Line	:
City	:	HOOVER
State	:	AL
Zip	:	35244-4021
Country	:	US
Telephone Number	:	205-682-7650
Fax Number	:	205-682-9040

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

Provider Enumeration Date	:	06/15/2006
Last Update Date	:	03/10/2015

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