Healthcare Provider Details

I. General information

NPI: 1972627297
Provider Name (Legal Business Name): SUSAN MARIE KRAMER OTR
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/19/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

800 LESLIE ST
NASHVILLE AR
71852-4015
US

IV. Provider business mailing address

800 LESLIE ST
NASHVILLE AR
71852-4015
US

V. Phone/Fax

Practice location:
  • Phone: 870-845-8161
  • Fax: 870-845-8284
Mailing address:
  • Phone: 870-845-8161
  • Fax: 870-845-8284

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License NumberOTR1895
License Number StateAR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: