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NPI Code Detail

MEDICARE: DAVID N DOUCETTE OTR

MEDICARE: DAVID N DOUCETTE OTR
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 Therapist5201010788MI

General Provider Information

NPI Number : 1518597459
Entity Type Code : Individual
Provider Name (Legal Business Name) : DAVID N DOUCETTE OTR
Provider Business Mailing Address
First Line : 1171 W CONWAY RD
Second Line :
City : HARBOR SPRINGS
State : MI
Zip : 49740-9684
Country : US
Telephone Number : 231-487-6163
Fax Number :
Provider Business Practice Location Address
First Line : 1171 W CONWAY RD
Second Line :
City : HARBOR SPRINGS
State : MI
Zip : 49740-9684
Country : US
Telephone Number : 231-487-6163
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/20/2020
Last Update Date : 01/20/2020

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Directions to “ DAVID N DOUCETTE OTR” Practice Location

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