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NPI Code Detail

MEDICARE: MISS ABIGAIL LYLE OTR/L

MEDICARE: MISS ABIGAIL LYLE 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
1225X00000XOccupational Therapist119091TX

General Provider Information

NPI Number : 1659835874
Entity Type Code : Individual
Provider Name (Legal Business Name) : MISS ABIGAIL LYLE OTR/L
Provider Business Mailing Address
First Line : 25 WATERS EDGE CIR APT 233
Second Line :
City : GEORGETOWN
State : TX
Zip : 78626-5562
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 763 MARLANDWOOD RD
Second Line :
City : TEMPLE
State : TX
Zip : 76502-3573
Country : US
Telephone Number : 307-620-9834
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/23/2019
Last Update Date : 01/23/2019

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Directions to “ MISS ABIGAIL LYLE OTR/L” Practice Location

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