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NPI Code Detail

MEDICARE: MELISSA TABOR

MEDICARE: MELISSA TABOR
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 TherapistR5472KY

General Provider Information

NPI Number : 1366785057
Entity Type Code : Individual
Provider Name (Legal Business Name) : MELISSA TABOR
Provider Business Mailing Address
First Line : PO BOX 974
Second Line :
City : GOSHEN
State : NY
Zip : 10924-0974
Country : US
Telephone Number : 845-615-1585
Fax Number : 845-615-1576
Provider Business Practice Location Address
First Line : 2520 REGENCY RD
Second Line : SUITE 150
City : LEXINGTON
State : KY
Zip : 40503-2921
Country : US
Telephone Number : 859-224-0834
Fax Number : 859-224-0882
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/01/2013
Last Update Date : 07/08/2013

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Directions to “ MELISSA TABOR ” Practice Location

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