MEDICARE: MRS. AMANDA CHRISTINE MEIXSELL 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	OC011542	PA

General Provider Information

NPI Number	:	1174825582
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. AMANDA CHRISTINE MEIXSELL OTR/L

Provider Business Mailing Address
First Line	:	2760 PINE GROVE RD
Second Line	:
City	:	LEADER HEIGHTS / YORK
State	:	PA
Zip	:	17403
Country	:	US
Telephone Number	:	717-741-1250
Fax Number	:	717-741-1251

Provider Business Practice Location Address
First Line	:	2760 PINE GROVE RD
Second Line	:
City	:	LEADER HEIGHTS / YORK
State	:	PA
Zip	:	17403
Country	:	US
Telephone Number	:	717-741-1250
Fax Number	:	717-741-1251

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

Provider Enumeration Date	:	11/18/2010
Last Update Date	:	02/04/2014

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