MEDICARE: RONNY L SAVAGE 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
1	225X00000X	Occupational Therapist	OT23183	FL
2	225X00000X	Occupational Therapist	OT71	CA
3	225XH1200X	Hand Occupational Therapist	OT23183	FL

General Provider Information

NPI Number	:	1528266541
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	RONNY L SAVAGE OT

Provider Business Mailing Address
First Line	:	PO BOX 117345
Second Line	:
City	:	ATLANTA
State	:	GA
Zip	:	30368-7345
Country	:	US
Telephone Number	:	904-346-3465
Fax Number	:	904-858-6489

Provider Business Practice Location Address
First Line	:	1747 BAPTIST CLAY DR STE 210
Second Line	:
City	:	FLEMING ISLAND
State	:	FL
Zip	:	32003-8505
Country	:	US
Telephone Number	:	904-621-0396
Fax Number	:	904-621-0397

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

Provider Enumeration Date	:	07/11/2007
Last Update Date	:	02/06/2023

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