Healthcare Provider Details

I. General information

NPI: 1982946059
Provider Name (Legal Business Name): JAMIE E OCHENDUSZKO OTR/L
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/26/2013
Last Update Date: 03/26/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

804 CRANDALL HALL
FLORENCE SC
29501-1489
US

IV. Provider business mailing address

804 CRANDALL HALL
FLORENCE SC
29501-1489
US

V. Phone/Fax

Practice location:
  • Phone: 419-410-6371
  • Fax:
Mailing address:
  • Phone: 419-410-6371
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225XP0019X
TaxonomyPhysical Rehabilitation Occupational Therapist
License Number2960
License Number StateSC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: