MEDICARE: GERALD OLER 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
1	225X00000X	Occupational Therapist	31007775A	IN

General Provider Information

NPI Number	:	1083493084
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	GERALD OLER OTR

Provider Business Mailing Address
First Line	:	1121 E LASALLE AVE
Second Line	:
City	:	SOUTH BEND
State	:	IN
Zip	:	46617-3321
Country	:	US
Telephone Number	:	574-287-6501
Fax Number	:

Provider Business Practice Location Address
First Line	:	1520 ENCHANTED FOREST ST
Second Line	:
City	:	SOUTH BEND
State	:	IN
Zip	:	46637-4740
Country	:	US
Telephone Number	:	574-404-1524
Fax Number	:

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

Provider Enumeration Date	:	09/28/2023
Last Update Date	:	04/13/2026

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Directions to “ GERALD OLER OTR” Practice Location

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