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NPI Code Detail

MEDICARE: MR. JEFFREY ALLEN VANFLEET OTR/L

MEDICARE: MR. JEFFREY ALLEN VANFLEET OTR/L
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 Therapist3037NC

General Provider Information

NPI Number : 1023285822
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. JEFFREY ALLEN VANFLEET OTR/L
Provider Business Mailing Address
First Line : 6312 WILLOWLAWN DR
Second Line :
City : WAKE FOREST
State : NC
Zip : 27587-7808
Country : US
Telephone Number : 919-570-8124
Fax Number :
Provider Business Practice Location Address
First Line : 616 WADE AVE
Second Line :
City : RALEIGH
State : NC
Zip : 27605-1237
Country : US
Telephone Number : 919-828-6251
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/12/2008
Last Update Date : 05/12/2008

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