MEDICARE: MRS. LINEE MARIE TOURDOT M.S., 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	225XP0200X	Pediatric Occupational Therapist	OC010647	PA

General Provider Information

NPI Number	:	1073782421
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. LINEE MARIE TOURDOT M.S., OTR/L

Provider Business Mailing Address
First Line	:	130 PINEWOOD DR
Second Line	:
City	:	BRIDGEVILLE
State	:	PA
Zip	:	15017-1220
Country	:	US
Telephone Number	:	724-747-4874
Fax Number	:

Provider Business Practice Location Address
First Line	:	9800B MCKNIGHT RD
Second Line	:	SUITE 228
City	:	PITTSBURGH
State	:	PA
Zip	:	15237-6020
Country	:	US
Telephone Number	:	877-347-5711
Fax Number	:	412-364-5195

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

Provider Enumeration Date	:	02/29/2008
Last Update Date	:	02/29/2008

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