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NPI Code Detail

MEDICARE: FUNCTIONAL PATHWAYS

MEDICARE: FUNCTIONAL PATHWAYS
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 Therapist2394AL

General Provider Information

NPI Number : 1194214262
Entity Type Code : Organization
Provider Name (Legal Business Name) : FUNCTIONAL PATHWAYS
Provider Business Mailing Address
First Line : 717 MARINA PARK DR SE
Second Line :
City : HUNTSVILLE
State : AL
Zip : 35803-3034
Country : US
Telephone Number : 256-684-3368
Fax Number :
Provider Business Practice Location Address
First Line : 12000 TURNMEYER DR SE
Second Line :
City : HUNTSVILLE
State : AL
Zip : 35803-3358
Country : US
Telephone Number : 256-684-3368
Fax Number :
Authorized Official
Title or Position : OCCUPATIONAL THERAPIST
Name : DR. MELLISA FANNING
Credential : OT
Telephone Number : 256-684-3368
Provider Enumeration Date : 05/04/2018
Last Update Date : 05/04/2018

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Directions to “FUNCTIONAL PATHWAYS ” Practice Location

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