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NPI Code Detail

MEDICARE: SAMANTHA LAUREN GORENTZ OTR/L

MEDICARE:   SAMANTHA LAUREN GORENTZ  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 TherapistOT.008601OH

General Provider Information

NPI Number : 1578981361
Entity Type Code : Individual
Provider Name (Legal Business Name) : SAMANTHA LAUREN GORENTZ OTR/L
Provider Business Mailing Address
First Line : 25221 MILES RD UNIT F
Second Line :
City : WARRENSVILLE HEIGHTS
State : OH
Zip : 44128-5494
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 25221 MILES RD UNIT F
Second Line :
City : WARRENSVILLE HEIGHTS
State : OH
Zip : 44128-5494
Country : US
Telephone Number : 216-514-1600
Fax Number : 216-292-3291
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/31/2014
Last Update Date : 03/31/2014

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Directions to “ SAMANTHA LAUREN GORENTZ OTR/L” Practice Location

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