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NPI Code Detail

MEDICARE: JENNIFER CRAIG OTD, OTR/L

MEDICARE:   JENNIFER  CRAIG  OTD, 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 Therapist4036TN

General Provider Information

NPI Number : 1023415916
Entity Type Code : Individual
Provider Name (Legal Business Name) : JENNIFER CRAIG OTD, OTR/L
Provider Business Mailing Address
First Line : 114 LIMERICK ST
Second Line :
City : MURFREESBORO
State : TN
Zip : 37129-8928
Country : US
Telephone Number : 615-848-8702
Fax Number :
Provider Business Practice Location Address
First Line : 825 FISHER AVE
Second Line :
City : SMITHVILLE
State : TN
Zip : 37166-2140
Country : US
Telephone Number : 615-597-4284
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/21/2014
Last Update Date : 11/21/2014

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