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NPI Code Detail

MEDICARE: JAMES G RAAB OTR

MEDICARE: JAMES G RAAB 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 Therapist439-026WI

General Provider Information

NPI Number : 1548434277
Entity Type Code : Individual
Provider Name (Legal Business Name) : JAMES G RAAB OTR
Provider Business Mailing Address
First Line : 718 JUPITER DR
Second Line :
City : MADISON
State : WI
Zip : 53718-2950
Country : US
Telephone Number : 608-663-8600
Fax Number : 608-251-2868
Provider Business Practice Location Address
First Line : 718 JUPITER DR
Second Line :
City : MADISON
State : WI
Zip : 53718-2950
Country : US
Telephone Number : 608-663-8600
Fax Number : 608-251-2868
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/14/2008
Last Update Date : 04/14/2008

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