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NPI Code Detail

MEDICARE: AMY SUE MACE

MEDICARE: AMY SUE MACE
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 TherapistOT007053GA

General Provider Information

NPI Number : 1902390057
Entity Type Code : Individual
Provider Name (Legal Business Name) : AMY SUE MACE
Provider Business Mailing Address
First Line : 4641 ROSWELL RD STE A
Second Line :
City : ATLANTA
State : GA
Zip : 30342-3073
Country : US
Telephone Number : 404-474-0506
Fax Number :
Provider Business Practice Location Address
First Line : 4641 ROSWELL RD STE A
Second Line :
City : ATLANTA
State : GA
Zip : 30342-3073
Country : US
Telephone Number : 404-474-0506
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/20/2018
Last Update Date : 06/20/2018

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Directions to “ AMY SUE MACE ” Practice Location

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