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NPI Code Detail

MEDICARE: MS. TARA JILL ACTON OTR/L

MEDICARE:  MS. TARA JILL ACTON  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
1225X00000XOccupational TherapistPHYO2055AK

General Provider Information

NPI Number : 1538465653
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. TARA JILL ACTON OTR/L
Provider Business Mailing Address
First Line : 1130 W DIMOND BLVD STE B
Second Line :
City : ANCHORAGE
State : AK
Zip : 99515-1511
Country : US
Telephone Number : 205-919-2228
Fax Number :
Provider Business Practice Location Address
First Line : 1130 W DIMOND BLVD STE B
Second Line :
City : ANCHORAGE
State : AK
Zip : 99515-1511
Country : US
Telephone Number : 205-919-2228
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/07/2011
Last Update Date : 09/01/2020

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Directions to “ MS. TARA JILL ACTON OTR/L” Practice Location

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