MEDICARE: MS. VICKI KAY ECKERT 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	1058615	IN

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	:	1144320078
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. VICKI KAY ECKERT OTR

Provider Business Mailing Address
First Line	:	6550 HIGHLAND LN
Second Line	:
City	:	MC CORDSVILLE
State	:	IN
Zip	:	46055-9533
Country	:	US
Telephone Number	:	317-336-6572
Fax Number	:

Provider Business Practice Location Address
First Line	:	6550 HIGHLAND LN
Second Line	:
City	:	MC CORDSVILLE
State	:	IN
Zip	:	46055-9533
Country	:	US
Telephone Number	:	317-336-6572
Fax Number	:

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

Provider Enumeration Date	:	09/22/2006
Last Update Date	:	07/09/2007

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