MEDICARE: ROBERT MCENDREE

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	224Z00000X	Occupational Therapy Assistant	04494	OH

General Provider Information

NPI Number	:	1487079463
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ROBERT MCENDREE

Provider Business Mailing Address
First Line	:	4640 WHITE ANGEL DR
Second Line	:
City	:	PERRY
State	:	OH
Zip	:	44081-9201
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	4640 WHITE ANGEL DR
Second Line	:
City	:	PERRY
State	:	OH
Zip	:	44081-9201
Country	:	US
Telephone Number	:	440-344-3412
Fax Number	:

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

Provider Enumeration Date	:	02/27/2014
Last Update Date	:	02/27/2014

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Directions to “ ROBERT MCENDREE ” Practice Location

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