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NPI Code Detail

MEDICARE: MR. STEVEN J JELLUM OTR

MEDICARE: MR. STEVEN J JELLUM OTR
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 Therapist30813OR
2225X00000XOccupational Therapist76HI
3225XP0019XPhysical Rehabilitation Occupational TherapistOT 12844FL
4225X00000XOccupational TherapistOC011917PA

General Provider Information

NPI Number : 1023239472
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. STEVEN J JELLUM OTR
Provider Business Mailing Address
First Line : 407 LAKE ST
Second Line :
City : EPHRATA
State : PA
Zip : 17522-2659
Country : US
Telephone Number : 717-615-2250
Fax Number :
Provider Business Practice Location Address
First Line : 3001 LITITZ PIKE
Second Line :
City : LITITZ
State : PA
Zip : 17543-9414
Country : US
Telephone Number : 800-367-9899
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/02/2007
Last Update Date : 03/11/2024

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