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NPI Code Detail

MEDICARE: MICHELLE EMERY DAVIS OTR/L

MEDICARE: MICHELLE EMERY DAVIS 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
1225X00000XOccupational Therapist8226MA

General Provider Information

NPI Number : 1134622830
Entity Type Code : Individual
Provider Name (Legal Business Name) : MICHELLE EMERY DAVIS OTR/L
Provider Business Mailing Address
First Line : 45 WOBURN ST
Second Line :
City : WALTHAM
State : MA
Zip : 02452-7919
Country : US
Telephone Number : 781-899-8600
Fax Number :
Provider Business Practice Location Address
First Line : 45 WOBURN ST
Second Line :
City : WALTHAM
State : MA
Zip : 02452-7919
Country : US
Telephone Number : 781-899-8600
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/09/2018
Last Update Date : 03/09/2018

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