MEDICARE: MS. JANICE SUSAN TOYOTA MS OTRL

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	OH-632	OH

General Provider Information

NPI Number	:	1649309048
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. JANICE SUSAN TOYOTA MS OTRL

Provider Business Mailing Address
First Line	:	15717 WYATT RD
Second Line	:
City	:	E CLEVELAND
State	:	OH
Zip	:	44112-4041
Country	:	US
Telephone Number	:	216-371-1911
Fax Number	:	216-321-9108

Provider Business Practice Location Address
First Line	:	14800 PRIVATE DR
Second Line	:
City	:	E CLEVELAND
State	:	OH
Zip	:	44112-3553
Country	:	US
Telephone Number	:	216-263-8213
Fax Number	:	216-761-4875

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

Provider Enumeration Date	:	03/04/2007
Last Update Date	:	07/08/2007

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