MEDICARE: DEBORAH A ELROD 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	004716	MO

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	:	1114147469
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DEBORAH A ELROD OTR L

Provider Business Mailing Address
First Line	:	1100 HIGH GROVE RD
Second Line	:
City	:	GRANDVIEW
State	:	MO
Zip	:	64030-2473
Country	:	US
Telephone Number	:	816-316-5047
Fax Number	:	816-316-5081

Provider Business Practice Location Address
First Line	:	CONSOLIDATED SCHOOL DIST 4
Second Line	:	1100 HIGH GROVE RD
City	:	GRANDVIEW
State	:	MO
Zip	:	64030-2473
Country	:	US
Telephone Number	:	816-316-5047
Fax Number	:	816-316-5081

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

Provider Enumeration Date	:	04/27/2007
Last Update Date	:	02/20/2009

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Directions to “ DEBORAH A ELROD OTR L” Practice Location

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