MEDICARE: ENABLE THERAPY SERVICES, LLC

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	0974	AZ

General Provider Information

NPI Number	:	1619268976
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ENABLE THERAPY SERVICES, LLC

Provider Business Mailing Address
First Line	:	12680 E FORT LOWELL RD
Second Line	:
City	:	TUCSON
State	:	AZ
Zip	:	85749-9614
Country	:	US
Telephone Number	:	520-760-7982
Fax Number	:

Provider Business Practice Location Address
First Line	:	12680 E FORT LOWELL RD
Second Line	:
City	:	TUCSON
State	:	AZ
Zip	:	85749-9614
Country	:	US
Telephone Number	:	520-760-7982
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	JEANNE M RODRIGUEZ
Credential	:	OTR/L
Telephone Number	:	520-760-7982

Provider Enumeration Date	:	04/21/2011
Last Update Date	:	04/21/2011

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Directions to “ENABLE THERAPY SERVICES, LLC ” Practice Location

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