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NPI Code Detail

MEDICARE: ELIZABETH THORNTON

MEDICARE: ELIZABETH THORNTON
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
1224Z00000XOccupational Therapy Assistant173-27WI

General Provider Information

NPI Number : 1235289497
Entity Type Code : Individual
Provider Name (Legal Business Name) : ELIZABETH THORNTON
Provider Business Mailing Address
First Line : 245 S FRANKLIN ST
Second Line :
City : OCONTO FALLS
State : WI
Zip : 54154-1426
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 831 PINE BEACH RD
Second Line :
City : MARINETTE
State : WI
Zip : 54143-4225
Country : US
Telephone Number : 715-732-5796
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/11/2007
Last Update Date : 07/08/2007

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Directions to “ ELIZABETH THORNTON ” Practice Location

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