Healthcare Provider Details

I. General information

NPI: 1003442963
Provider Name (Legal Business Name): ANN CULVER OTD, OTR/L
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/22/2020
Last Update Date: 03/22/2020
Certification Date: 03/22/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6301 E 125TH ST
GRANDVIEW MO
64030-1884
US

IV. Provider business mailing address

6501 E 137TH ST
GRANDVIEW MO
64030-3722
US

V. Phone/Fax

Practice location:
  • Phone: 816-765-7714
  • Fax:
Mailing address:
  • Phone: 608-333-8430
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number20877
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: