MEDICARE: MRS. ALLISON NANCE 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
1	225X00000X	Occupational Therapist

General Provider Information

NPI Number	:	1265248587
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. ALLISON NANCE OTR/L

Provider Business Mailing Address
First Line	:	113 RIDGEWAY DR
Second Line	:
City	:	PRINCETON
State	:	WV
Zip	:	24740-9775
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1600 BLAND ST
Second Line	:
City	:	BLUEFIELD
State	:	WV
Zip	:	24701-3775
Country	:	US
Telephone Number	:	304-809-5557
Fax Number	:

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

Provider Enumeration Date	:	12/10/2024
Last Update Date	:	12/10/2024

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