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NPI Code Detail

MEDICARE: AMANDA REN'A GREENE OT

MEDICARE: AMANDA REN'A GREENE OT
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 Therapist3629TN

General Provider Information

NPI Number : 1437225901
Entity Type Code : Individual
Provider Name (Legal Business Name) : AMANDA REN'A GREENE OT
Provider Business Mailing Address
First Line : 640 W ANTIOCH RD
Second Line :
City : SPRINGVILLE
State : TN
Zip : 38256-4410
Country : US
Telephone Number : 931-624-5391
Fax Number :
Provider Business Practice Location Address
First Line : 800 VOLUNTEER DR
Second Line :
City : PARIS
State : TN
Zip : 38242-5472
Country : US
Telephone Number : 731-642-2535
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/28/2006
Last Update Date : 07/08/2007

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Directions to “ AMANDA REN'A GREENE OT” Practice Location

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