MEDICARE: CAROL L ORR

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	0787	NV

General Provider Information

NPI Number	:	1134470669
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CAROL L ORR

Provider Business Mailing Address
First Line	:	10257 BAYHEAD BEACH AVE
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89135-1134
Country	:	US
Telephone Number	:	702-862-0955
Fax Number	:

Provider Business Practice Location Address
First Line	:	10257 BAYHEAD BEACH AVE
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89135-1134
Country	:	US
Telephone Number	:	702-862-0955
Fax Number	:

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

Provider Enumeration Date	:	09/24/2012
Last Update Date	:	09/24/2012

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Directions to “ CAROL L ORR ” Practice Location

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