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General NPI Number Information
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NPI Number | 1700038585
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Entity Type | Organization
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Legal Business Name | INDEPENDENT OCCUPATIONAL THERAPY, INC.
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Dates
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Enumeration Date | 10/11/2008
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Last Update Date | 10/08/2010
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Provider Practice Location Address
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Address Line | 732B S LUMINA AVE
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City | WRIGHTSVILLE BEACH
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State | NC
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Zip | 28480-2168
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Country | US
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Telephone | 910-520-2702
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Fax | 910-509-9397
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Provider Business Mailing Address
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Address Line | PO BOX 1437
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City | WRIGHTSVILLE BEACH
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State | NC
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Zip | 28480-1437
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Country | US
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Telephone | 910-520-2702
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Fax | 910-509-9397
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Authorized Official
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Title or Position | OWNER
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Name | SETH JAMES BERKEBILE
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Credential | MS, OTR/L
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Telephone | 910-520-2702
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number | 5204
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License Number State | NC
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