MEDICARE: JULIA JANICE KYRAMARIOS

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	2002001904	MO

General Provider Information

NPI Number	:	1285903898
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JULIA JANICE KYRAMARIOS

Provider Business Mailing Address
First Line	:	1034 S BRENTWOOD BLVD
Second Line	:	SUITE 300
City	:	RICHMOND HEIGHTS
State	:	MO
Zip	:	63117-1223
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1034 S BRENTWOOD BLVD
Second Line	:	SUITE 300
City	:	RICHMOND HEIGHTS
State	:	MO
Zip	:	63117-1223
Country	:	US
Telephone Number	:	314-644-1978
Fax Number	:

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

Provider Enumeration Date	:	12/28/2011
Last Update Date	:	12/28/2011

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