MEDICARE: MS. PATRICIA L SHIMKO 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
1	225X00000X	Occupational Therapist	OT-002768	OH

General Provider Information

NPI Number	:	1578737508
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. PATRICIA L SHIMKO OTR/L

Provider Business Mailing Address
First Line	:	20370 LORAIN RD
Second Line	:
City	:	FAIRVIEW PARK
State	:	OH
Zip	:	44126-3411
Country	:	US
Telephone Number	:	440-356-3213
Fax Number	:	440-331-0453

Provider Business Practice Location Address
First Line	:	20370 LORAIN RD
Second Line	:
City	:	FAIRVIEW PARK
State	:	OH
Zip	:	44126-3411
Country	:	US
Telephone Number	:	440-356-3213
Fax Number	:	440-331-0453

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

Provider Enumeration Date	:	04/22/2008
Last Update Date	:	04/22/2008

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