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NPI Code Detail

MEDICARE: MRS. CHRISTY SURGEONER OTR/L

MEDICARE: MRS. CHRISTY SURGEONER 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
1225XP0200XPediatric Occupational Therapist0119002506VA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1447276035
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. CHRISTY SURGEONER OTR/L
Provider Business Mailing Address
First Line : 4016 RAINTREE RD
Second Line : SUITE 240
City : CHESAPEAKE
State : VA
Zip : 23321-3700
Country : US
Telephone Number : 757-488-2864
Fax Number : 757-488-4735
Provider Business Practice Location Address
First Line : 4016 RAINTREE RD
Second Line : SUITE 240
City : CHESAPEAKE
State : VA
Zip : 23321-3700
Country : US
Telephone Number : 757-488-2864
Fax Number : 757-488-4735
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/15/2006
Last Update Date : 07/08/2007

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Directions to “ MRS. CHRISTY SURGEONER OTR/L” Practice Location

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