MEDICARE: OCCUPATIONAL THERAPY CONNECTIONS 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

General Provider Information

NPI Number	:	1639598253
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	OCCUPATIONAL THERAPY CONNECTIONS LLC

Provider Business Mailing Address
First Line	:	6801 LAKE PLAZA DR
Second Line	:	SUITE A101A
City	:	INDIANAPOLIS
State	:	IN
Zip	:	46220-4061
Country	:	US
Telephone Number	:	317-581-1185
Fax Number	:	317-581-1355

Provider Business Practice Location Address
First Line	:	6801 LAKE PLAZA DR
Second Line	:	SUITE A101A
City	:	INDIANAPOLIS
State	:	IN
Zip	:	46220-4061
Country	:	US
Telephone Number	:	317-581-1185
Fax Number	:	317-581-1355

Authorized Official
Title or Position	:	OWNER
Name	:	CAROL J NEU FRAUMAN
Credential	:	OTR
Telephone Number	:	317-581-1185

Provider Enumeration Date	:	04/10/2014
Last Update Date	:	04/10/2014

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