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NPI Code Detail

MEDICARE: MRS. TAMRA CARLSON MANN OTR/L

MEDICARE: MRS. TAMRA CARLSON MANN 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 Therapist0115AL

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1515-30477OTHERALBLUE CROSS BLUE SHIELD PR

General Provider Information

NPI Number : 1568561322
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. TAMRA CARLSON MANN OTR/L
Provider Business Mailing Address
First Line : 873 DEERBROOK DR
Second Line :
City : GARDENDALE
State : AL
Zip : 35071-3241
Country : US
Telephone Number : 205-647-5527
Fax Number :
Provider Business Practice Location Address
First Line : 245 CAHABA VALLEY PKWY
Second Line : SUITE 200
City : PELHAM
State : AL
Zip : 35124-2216
Country : US
Telephone Number : 205-942-6820
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/21/2006
Last Update Date : 07/08/2007

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Directions to “ MRS. TAMRA CARLSON MANN OTR/L” Practice Location

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