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General NPI Number Information
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NPI Number | 1366267668
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Entity Type | Individual
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Provider Name | JAMES DICK OTR/L
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Gender | Male
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Dates
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Enumeration Date | 11/21/2024
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Last Update Date | 11/21/2024
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Provider Practice Location Address
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Address Line | 1415 MAPLE ST
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City | EUDORA
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State | KS
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Zip | 66025-9419
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Country | US
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Telephone | 785-542-2176
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Fax |
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Provider Business Mailing Address
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Address Line | 522 E 129TH TER
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City | KANSAS CITY
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State | MO
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Zip | 64145-1355
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Country | US
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Telephone | 913-278-9387
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225X00000X
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Taxonomy Name | Occupational Therapist
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License Number | 17-03428
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License Number State | KS
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