MEDICARE: AMY JACQUELINE ZOCH MOTRL

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	225XP0200X	Pediatric Occupational Therapist	7896	NC
2	225X00000X	Occupational Therapist	7896	NC

General Provider Information

NPI Number	:	1225326572
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	AMY JACQUELINE ZOCH MOTRL

Provider Business Mailing Address
First Line	:	5908 CHASON RIDGE DR
Second Line	:	APT. E
City	:	FAYETTEVILLE
State	:	NC
Zip	:	28314-4852
Country	:	US
Telephone Number	:	248-212-3750
Fax Number	:

Provider Business Practice Location Address
First Line	:	1289 OLIVER ST
Second Line	:
City	:	FAYETTEVILLE
State	:	NC
Zip	:	28304-4450
Country	:	US
Telephone Number	:	910-483-8331
Fax Number	:

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

Provider Enumeration Date	:	07/20/2011
Last Update Date	:	05/18/2015

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