MEDICARE: JODY L HEYMAN OT

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	225X00000X	Occupational Therapist	OT002643	OH

General Provider Information

NPI Number	:	1568412187
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JODY L HEYMAN OT

Provider Business Mailing Address
First Line	:	35755 SPATTERDOCK LN
Second Line	:
City	:	SOLON
State	:	OH
Zip	:	44139-6502
Country	:	US
Telephone Number	:	440-542-9167
Fax Number	:

Provider Business Practice Location Address
First Line	:	781 BETA DR
Second Line	:	SUITE C
City	:	CLEVELAND
State	:	OH
Zip	:	44143-2356
Country	:	US
Telephone Number	:	440-460-0344
Fax Number	:	440-460-1767

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

Provider Enumeration Date	:	05/12/2006
Last Update Date	:	10/19/2007

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