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NPI Code Detail

MEDICARE: JAMIE ANN COBURN VAN HORN OT

MEDICARE: JAMIE ANN COBURN VAN HORN OT
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1225X00000XOccupational TherapistOTR1641KY
2225X00000XOccupational TherapistOT03999OH
3225X00000XOccupational TherapistOT-003999OH

General Provider Information

NPI Number : 1013094572
Entity Type Code : Individual
Provider Name (Legal Business Name) : JAMIE ANN COBURN VAN HORN OT
Provider Business Mailing Address
First Line : 1550 OLD HENDERSON RD STE S-204
Second Line :
City : COLUMBUS
State : OH
Zip : 43220-3626
Country : US
Telephone Number : 614-824-2633
Fax Number : 614-726-2399
Provider Business Practice Location Address
First Line : 1550 OLD HENDERSON RD STE S-204
Second Line :
City : COLUMBUS
State : OH
Zip : 43220-3626
Country : US
Telephone Number : 614-824-2633
Fax Number : 614-467-3841
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/01/2006
Last Update Date : 12/28/2020

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