MEDICARE: MICHAEL JOSEPH TOWER OT, CHT

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	009101-1	NY
2	225XH1200X	Hand Occupational Therapist	009101-1	NY

General Provider Information

NPI Number	:	1295903649
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MICHAEL JOSEPH TOWER OT, CHT

Provider Business Mailing Address
First Line	:	1391 ROUTE 9
Second Line	:
City	:	FORT EDWARD
State	:	NY
Zip	:	12828-2462
Country	:	US
Telephone Number	:	518-793-0891
Fax Number	:

Provider Business Practice Location Address
First Line	:	1391 ROUTE 9
Second Line	:
City	:	FORT EDWARD
State	:	NY
Zip	:	12828-2462
Country	:	US
Telephone Number	:	518-793-0891
Fax Number	:

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

Provider Enumeration Date	:	02/19/2008
Last Update Date	:	02/19/2008

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