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NPI Code Detail

MEDICARE: JAMES MATHERNE

MEDICARE: JAMES MATHERNE
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 Therapist
2106S00000XBehavior Technician

General Provider Information

NPI Number : 1831738038
Entity Type Code : Individual
Provider Name (Legal Business Name) : JAMES MATHERNE
Provider Business Mailing Address
First Line : 7110 MICHIGAN RD
Second Line :
City : BAY CITY
State : MI
Zip : 48706-9310
Country : US
Telephone Number : 989-415-9289
Fax Number :
Provider Business Practice Location Address
First Line : 900 CENTER AVE
Second Line :
City : BAY CITY
State : MI
Zip : 48708-6189
Country : US
Telephone Number : 989-525-5337
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/06/2020
Last Update Date : 08/12/2022

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Directions to “ JAMES MATHERNE ” Practice Location

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