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General NPI Number Information
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NPI Number | 1659816379
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Entity Type | Individual
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Provider Name | TAM LE MOT
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Gender | Male
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Dates
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Enumeration Date | 01/04/2017
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Last Update Date | 09/17/2019
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Provider Practice Location Address
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Address Line | 820 COTTAGE ST NE
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City | SALEM
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State | OR
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Zip | 97301-2426
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Country | US
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Telephone | 954-338-8262
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Fax |
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Provider Business Mailing Address
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Address Line | 4316 SW 21ST LN
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City | GAINESVILLE
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State | FL
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Zip | 32607-3815
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Country | US
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Telephone | 954-338-8262
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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 | 283X00000X
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Taxonomy Name | Rehabilitation Hospital
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 225X00000X
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Taxonomy Name | Occupational Therapist
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License Number | 359551
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License Number State | OR
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