Healthcare Provider Details

I. General information

NPI: 1548974041
Provider Name (Legal Business Name): KAITLIN GROVER OTR/L
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/09/2023
Last Update Date: 06/02/2023
Certification Date: 06/02/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

200 LOTHROP ST
PITTSBURGH PA
15213-2536
US

IV. Provider business mailing address

600 GRANT ST FL 58
PITTSBURGH PA
15219-2739
US

V. Phone/Fax

Practice location:
  • Phone: 412-586-9819
  • Fax:
Mailing address:
  • Phone: 412-232-8111
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225XP0019X
TaxonomyPhysical Rehabilitation Occupational Therapist
License NumberOC018685
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: