MEDICARE: ECKMAN & RACH OCCUPATIONAL THERAPY, CORPORATION

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	225XH1200X	Hand Occupational Therapist	OT4416	CA

General Provider Information

NPI Number	:	1558510966
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ECKMAN & RACH OCCUPATIONAL THERAPY, CORPORATION

Provider Business Mailing Address
First Line	:	333 N PALM CANYON DR
Second Line	:	SUITE 115
City	:	PALM SPRINGS
State	:	CA
Zip	:	92262-5658
Country	:	US
Telephone Number	:	760-408-0706
Fax Number	:

Provider Business Practice Location Address
First Line	:	333 N PALM CANYON DR
Second Line	:	SUITE 115
City	:	PALM SPRINGS
State	:	CA
Zip	:	92262-5658
Country	:	US
Telephone Number	:	760-408-0706
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	ERIC E CARINO
Credential	:	O.T.
Telephone Number	:	760-408-0706

Provider Enumeration Date	:	09/10/2008
Last Update Date	:	09/10/2008

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