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General NPI Number Information
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NPI Number | 1912264961
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Entity Type | Individual
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Provider Name | JAYME LYNN KIRK OTR/L
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Gender | Female
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Dates
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Enumeration Date | 04/16/2012
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Last Update Date | 06/23/2014
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Provider Practice Location Address
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Address Line | 28 CROSSWINDS CIR
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City | SANFORD
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State | NC
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Zip | 27332-1558
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Country | US
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Telephone | 734-497-4446
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Fax |
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Provider Business Mailing Address
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Address Line | 28 CROSSWINDS CIR
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City | SANFORD
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State | NC
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Zip | 27332-1558
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Country | US
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Telephone | 734-497-4446
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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 | 8256
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License Number State | NC
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