MEDICARE: DARIUS REDMOND 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
1	225X00000X	Occupational Therapist

General Provider Information

NPI Number	:	1427666833
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DARIUS REDMOND OTR/L

Provider Business Mailing Address
First Line	:	2440 VINE ST
Second Line	:
City	:	UNION CITY
State	:	GA
Zip	:	30291-6067
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	21045 N 9TH PL
Second Line	:
City	:	PHOENIX
State	:	AZ
Zip	:	85024-5634
Country	:	US
Telephone Number	:	602-726-2300
Fax Number	:

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

Provider Enumeration Date	:	07/21/2020
Last Update Date	:	07/21/2020

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Directions to “ DARIUS REDMOND OTR/L” Practice Location

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