MEDICARE: HOLLY D HILLYER 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
1	225X00000X	Occupational Therapist	719	NE

General Provider Information

NPI Number	:	1912078056
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	HOLLY D HILLYER OT

Provider Business Mailing Address
First Line	:	10905 COTTONWOOD LN
Second Line	:
City	:	OMAHA
State	:	NE
Zip	:	68164-3715
Country	:	US
Telephone Number	:	402-657-3299
Fax Number	:

Provider Business Practice Location Address
First Line	:	10905 COTTONWOOD LN
Second Line	:
City	:	OMAHA
State	:	NE
Zip	:	68164-3715
Country	:	US
Telephone Number	:	402-657-3299
Fax Number	:

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

Provider Enumeration Date	:	11/12/2006
Last Update Date	:	07/08/2007

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Directions to “ HOLLY D HILLYER OT” Practice Location

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