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NPI Code Detail

MEDICARE: ELEANOR MACLEOD MS OTR/L

MEDICARE: ELEANOR MACLEOD MS 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
1225X00000XOccupational Therapist9544MA

General Provider Information

NPI Number : 1316118094
Entity Type Code : Individual
Provider Name (Legal Business Name) : ELEANOR MACLEOD MS OTR/L
Provider Business Mailing Address
First Line : 5911 APACHE RD
Second Line :
City : LOUISVILLE
State : KY
Zip : 40207-1717
Country : US
Telephone Number : 502-649-8987
Fax Number :
Provider Business Practice Location Address
First Line : 4603 TIMBERWALK CT
Second Line :
City : LA GRANGE
State : KY
Zip : 40031-6746
Country : US
Telephone Number : 703-386-4669
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/20/2008
Last Update Date : 03/27/2020

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