MEDICARE: MRS. MARLA PRYOR C.O.T.A./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
1	224Z00000X	Occupational Therapy Assistant	2007026366	MO

General Provider Information

NPI Number	:	1538503776
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. MARLA PRYOR C.O.T.A./L

Provider Business Mailing Address
First Line	:	285 NE ADAMS DAIRY PKWY
Second Line	:
City	:	BLUE SPRINGS
State	:	MO
Zip	:	64014-5450
Country	:	US
Telephone Number	:	816-977-7569
Fax Number	:

Provider Business Practice Location Address
First Line	:	7001 CLEVELAND AVE
Second Line	:
City	:	KANSAS CITY
State	:	MO
Zip	:	64132-1622
Country	:	US
Telephone Number	:	816-444-5327
Fax Number	:

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

Provider Enumeration Date	:	04/18/2013
Last Update Date	:	04/18/2013

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