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NPI Code Detail

MEDICARE: KRISTI L WANKER OT

MEDICARE: KRISTI L WANKER OT
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 Therapist4819OH

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1225362676
Entity Type Code : Individual
Provider Name (Legal Business Name) : KRISTI L WANKER OT
Provider Business Mailing Address
First Line : 1325 CHURCHILL HUBBARD RD
Second Line :
City : YOUNGSTOWN
State : OH
Zip : 44505-1346
Country : US
Telephone Number : 330-759-5904
Fax Number : 330-759-8709
Provider Business Practice Location Address
First Line : 2675 N LIPKEY RD
Second Line :
City : NORTH JACKSON
State : OH
Zip : 44451-9665
Country : US
Telephone Number : 330-538-6228
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/01/2009
Last Update Date : 10/01/2009

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Directions to “ KRISTI L WANKER OT” Practice Location

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