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NPI Code Detail

MEDICARE: TAYLOR L EUBANK OTR/L

MEDICARE: TAYLOR L EUBANK 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 Therapist0119009056VA

General Provider Information

NPI Number : 1326614652
Entity Type Code : Individual
Provider Name (Legal Business Name) : TAYLOR L EUBANK OTR/L
Provider Business Mailing Address
First Line : 3361 FOREST RIDGE RD
Second Line :
City : ROANOKE
State : VA
Zip : 24018-5083
Country : US
Telephone Number : 540-556-6928
Fax Number :
Provider Business Practice Location Address
First Line : 4355 PHEASANT RIDGE RD
Second Line :
City : ROANOKE
State : VA
Zip : 24014-5272
Country : US
Telephone Number : 540-725-8210
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/27/2021
Last Update Date : 05/27/2021

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Directions to “ TAYLOR L EUBANK OTR/L” Practice Location

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