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NPI Code Detail

MEDICARE: MS. MOLLY ANN BARTLETT

MEDICARE: MS. MOLLY ANN BARTLETT
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
1224Z00000XOccupational Therapy AssistantOT-A718AR

General Provider Information

NPI Number : 1073862413
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. MOLLY ANN BARTLETT
Provider Business Mailing Address
First Line : 101 E STATE ST
Second Line :
City : KENNETT SQUARE
State : PA
Zip : 19348-3109
Country : US
Telephone Number : 800-728-8808
Fax Number :
Provider Business Practice Location Address
First Line : 1513 S DIXIELAND RD
Second Line :
City : ROGERS
State : AR
Zip : 72758-4935
Country : US
Telephone Number : 479-636-5841
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/30/2012
Last Update Date : 08/30/2012

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