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NPI Code Detail

MEDICARE: MS. MEGAN MICHELE DIETZ OT

MEDICARE:  MS. MEGAN MICHELE DIETZ  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
1225X00000XOccupational TherapistOC010211PA

General Provider Information

NPI Number : 1669541439
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. MEGAN MICHELE DIETZ OT
Provider Business Mailing Address
First Line : 2 HOME ST
Second Line :
City : JOHNSTOWN
State : PA
Zip : 15906-3221
Country : US
Telephone Number : 814-536-5864
Fax Number :
Provider Business Practice Location Address
First Line : 128 LOGAN BLVD
Second Line :
City : HOLLIDAYSBURG
State : PA
Zip : 16648-2604
Country : US
Telephone Number : 814-317-1081
Fax Number : 814-317-1081
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/07/2006
Last Update Date : 07/08/2007

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Directions to “ MS. MEGAN MICHELE DIETZ OT” Practice Location

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