MEDICARE: NATALIE A BRYANT MOTR/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	224Z00000X	Occupational Therapy Assistant	1816	OK
2	225X00000X	Occupational Therapist	5643	OK

General Provider Information

NPI Number	:	1174193775
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	NATALIE A BRYANT MOTR/L

Provider Business Mailing Address
First Line	:	1625 NW 147TH ST
Second Line	:
City	:	EDMOND
State	:	OK
Zip	:	73013-2481
Country	:	US
Telephone Number	:	580-650-8094
Fax Number	:

Provider Business Practice Location Address
First Line	:	9070 HARMONY DR STE A
Second Line	:
City	:	MIDWEST CITY
State	:	OK
Zip	:	73130-6257
Country	:	US
Telephone Number	:	405-455-5582
Fax Number	:

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

Provider Enumeration Date	:	06/28/2021
Last Update Date	:	02/11/2022

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Directions to “ NATALIE A BRYANT MOTR/L” Practice Location

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