MEDICARE: MRS. AIMEE DEVON ADAMS M, 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	1597	NC

General Provider Information

NPI Number	:	1871763052
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. AIMEE DEVON ADAMS M, OTR/L

Provider Business Mailing Address
First Line	:	3728 LIME ROCK RD
Second Line	:
City	:	EAST BEND
State	:	NC
Zip	:	27018-7636
Country	:	US
Telephone Number	:	336-699-3899
Fax Number	:	336-699-3899

Provider Business Practice Location Address
First Line	:	3728 LIME ROCK RD
Second Line	:
City	:	EAST BEND
State	:	NC
Zip	:	27018-7636
Country	:	US
Telephone Number	:	336-699-3899
Fax Number	:	336-699-3899

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

Provider Enumeration Date	:	03/04/2008
Last Update Date	:	03/04/2008

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