MEDICARE: MS. ROBIN BRYANT MS. 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
1	225X00000X	Occupational Therapist	31004522A	IN

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1043493091
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. ROBIN BRYANT MS. OTR/L

Provider Business Mailing Address
First Line	:	4212 CHARLESTOWN RD STE 3
Second Line	:
City	:	NEW ALBANY
State	:	IN
Zip	:	47150-9487
Country	:	US
Telephone Number	:	812-949-3272
Fax Number	:	812-949-3271

Provider Business Practice Location Address
First Line	:	4212 CHARLESTOWN RD STE 3
Second Line	:
City	:	NEW ALBANY
State	:	IN
Zip	:	47150-9487
Country	:	US
Telephone Number	:	812-949-3272
Fax Number	:	812-949-3271

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/13/2007
Last Update Date	:	12/13/2007

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