MEDICARE: MS. JODI MICHELLE NEWMAN OTR/L

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	005820	OH

General Provider Information

NPI Number	:	1649416744
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. JODI MICHELLE NEWMAN OTR/L

Provider Business Mailing Address
First Line	:	1616 BROOKDALE AVE
Second Line	:
City	:	PARMA
State	:	OH
Zip	:	44134-1610
Country	:	US
Telephone Number	:	216-346-7832
Fax Number	:

Provider Business Practice Location Address
First Line	:	34143 CENTER RIDGE RD
Second Line	:
City	:	NORTH RIDGEVILLE
State	:	OH
Zip	:	44039-3221
Country	:	US
Telephone Number	:	216-346-7832
Fax Number	:

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

Provider Enumeration Date	:	12/20/2008
Last Update Date	:	12/20/2008

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