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NPI Code Detail

MEDICARE: ANDREA STAHL

MEDICARE: ANDREA STAHL
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 TherapistOT001256GA

General Provider Information

NPI Number : 1275699605
Entity Type Code : Individual
Provider Name (Legal Business Name) : ANDREA STAHL
Provider Business Mailing Address
First Line : 49 MOUNTAIN CHASE RD SW
Second Line :
City : ROME
State : GA
Zip : 30165-8577
Country : US
Telephone Number : 770-547-4380
Fax Number :
Provider Business Practice Location Address
First Line : 304 E 6TH AVE
Second Line :
City : ROME
State : GA
Zip : 30161-6000
Country : US
Telephone Number : 706-378-9044
Fax Number : 706-378-6046
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/29/2006
Last Update Date : 07/08/2007

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Directions to “ ANDREA STAHL ” Practice Location

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