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NPI Code Detail

MEDICARE: DEBORAH RAE SOLOMON OTR

MEDICARE: DEBORAH RAE SOLOMON 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 Therapist1702317KS

General Provider Information

NPI Number : 1043402837
Entity Type Code : Individual
Provider Name (Legal Business Name) : DEBORAH RAE SOLOMON OTR
Provider Business Mailing Address
First Line : 2301 S WATER
Second Line :
City : WICHITA
State : KS
Zip : 67213-4819
Country : US
Telephone Number : 316-682-4646
Fax Number : 316-263-4116
Provider Business Practice Location Address
First Line : 2301 S WATER
Second Line :
City : WICHITA
State : KS
Zip : 67213-4819
Country : US
Telephone Number : 316-682-4646
Fax Number : 316-263-4116
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/15/2007
Last Update Date : 08/15/2007

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