MEDICARE: KIMBERLY ROYER

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	OT-1978	OH

General Provider Information

NPI Number	:	1306624291
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KIMBERLY ROYER

Provider Business Mailing Address
First Line	:	65 HESTON DR
Second Line	:
City	:	SPRINGBORO
State	:	OH
Zip	:	45066-1082
Country	:	US
Telephone Number	:	513-722-5234
Fax Number	:

Provider Business Practice Location Address
First Line	:	405 GRAFTON AVE
Second Line	:
City	:	DAYTON
State	:	OH
Zip	:	45406-5202
Country	:	US
Telephone Number	:	937-276-4040
Fax Number	:

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

Provider Enumeration Date	:	09/20/2023
Last Update Date	:	09/20/2023

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Directions to “ KIMBERLY ROYER ” Practice Location

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