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NPI Code Detail

MEDICARE: ALISA KIRKLIN

MEDICARE: ALISA KIRKLIN
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
1224Z00000XOccupational Therapy Assistant212924TX

General Provider Information

NPI Number : 1598244113
Entity Type Code : Individual
Provider Name (Legal Business Name) : ALISA KIRKLIN
Provider Business Mailing Address
First Line : 430 OLD AUSTIN HWY
Second Line :
City : BASTROP
State : TX
Zip : 78602-5168
Country : US
Telephone Number : 512-321-3579
Fax Number :
Provider Business Practice Location Address
First Line : 430 OLD AUSTIN HWY
Second Line :
City : BASTROP
State : TX
Zip : 78602-5168
Country : US
Telephone Number : 512-321-3579
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/14/2018
Last Update Date : 08/14/2018

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Directions to “ ALISA KIRKLIN ” Practice Location

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