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NPI Code Detail

MEDICARE: JOHANNA C NITZ OTR/L

MEDICARE: JOHANNA C NITZ 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
1225XP0200XPediatric Occupational Therapist1821OK

General Provider Information

NPI Number : 1285162768
Entity Type Code : Individual
Provider Name (Legal Business Name) : JOHANNA C NITZ OTR/L
Provider Business Mailing Address
First Line : 3268 PARADISE AVE
Second Line :
City : HILLIARD
State : OH
Zip : 43026-8517
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 1481 W TOWN ST
Second Line :
City : COLUMBUS
State : OH
Zip : 43223-1379
Country : US
Telephone Number : 614-276-8231
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/30/2017
Last Update Date : 05/30/2017

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