MEDICARE: MS. KAREN JEAN HARDWICK O.T.R.

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	891	OK

General Provider Information

NPI Number	:	1316011927
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. KAREN JEAN HARDWICK O.T.R.

Provider Business Mailing Address
First Line	:	2134 JAZZMAN DR
Second Line	:
City	:	NORMAN
State	:	OK
Zip	:	73071-2456
Country	:	US
Telephone Number	:	405-360-0652
Fax Number	:

Provider Business Practice Location Address
First Line	:	6400 N. SANTA FE, STE B
Second Line	:
City	:	OKLAHOMA CITY
State	:	OK
Zip	:	73116-9126
Country	:	US
Telephone Number	:	405-840-2903
Fax Number	:	405-840-3256

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

Provider Enumeration Date	:	11/17/2006
Last Update Date	:	07/08/2007

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