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NPI Code Detail

MEDICARE: KUSUM BHANA OTR/L

MEDICARE: KUSUM BHANA 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
1225XP0019XPhysical Rehabilitation Occupational Therapist5201003527MI

General Provider Information

NPI Number : 1518466630
Entity Type Code : Individual
Provider Name (Legal Business Name) : KUSUM BHANA OTR/L
Provider Business Mailing Address
First Line : 36195 POMPANO DR
Second Line :
City : STERLING HEIGHTS
State : MI
Zip : 48310-4581
Country : US
Telephone Number : 586-274-4229
Fax Number :
Provider Business Practice Location Address
First Line : 25990 CROCKER BLVD
Second Line :
City : HARRISON TOWNSHIP
State : MI
Zip : 48045-3450
Country : US
Telephone Number : 586-466-5324
Fax Number : 586-466-5397
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/04/2018
Last Update Date : 02/04/2018

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Directions to “ KUSUM BHANA OTR/L” Practice Location

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