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NPI Code Detail

MEDICARE: MALLORY SIEFKER OTR/L

MEDICARE: MALLORY SIEFKER 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
1225X00000XOccupational TherapistOT007823OH

General Provider Information

NPI Number : 1245699107
Entity Type Code : Individual
Provider Name (Legal Business Name) : MALLORY SIEFKER OTR/L
Provider Business Mailing Address
First Line : 1100 SHAWNEE RD
Second Line :
City : LIMA
State : OH
Zip : 45805-3529
Country : US
Telephone Number : 419-999-2010
Fax Number : 419-999-6284
Provider Business Practice Location Address
First Line : 2535 FORT AMANDA RD
Second Line :
City : LIMA
State : OH
Zip : 45804-3728
Country : US
Telephone Number : 419-999-2055
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/19/2016
Last Update Date : 11/01/2022

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Directions to “ MALLORY SIEFKER OTR/L” Practice Location

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