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NPI Code Detail

MEDICARE: AMANDA RIZZO OTR/L

MEDICARE: AMANDA RIZZO 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
1225XG0600XGerontology Occupational TherapistOT010975OH

General Provider Information

NPI Number : 1275134496
Entity Type Code : Individual
Provider Name (Legal Business Name) : AMANDA RIZZO OTR/L
Provider Business Mailing Address
First Line : 4279 MOSER LN
Second Line :
City : PERRYSBURG
State : OH
Zip : 43551-7186
Country : US
Telephone Number : 419-386-6780
Fax Number :
Provider Business Practice Location Address
First Line : 20311 PEMBERVILLE RD
Second Line :
City : PEMBERVILLE
State : OH
Zip : 43450-9413
Country : US
Telephone Number : 419-386-6780
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/04/2020
Last Update Date : 11/04/2020

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