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NPI Code Detail

MEDICARE: EMILY MARIE WHITE OTRL

MEDICARE: EMILY MARIE WHITE 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
1225X00000XOccupational Therapist5201009056MI

General Provider Information

NPI Number : 1649783960
Entity Type Code : Individual
Provider Name (Legal Business Name) : EMILY MARIE WHITE OTRL
Provider Business Mailing Address
First Line : 804 WOODSIDE LN
Second Line :
City : BAY CITY
State : MI
Zip : 48708-5559
Country : US
Telephone Number : 989-737-5263
Fax Number :
Provider Business Practice Location Address
First Line : 1200 WASHINGTON AVE
Second Line :
City : BAY CITY
State : MI
Zip : 48708-5756
Country : US
Telephone Number : 989-895-2035
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/08/2017
Last Update Date : 11/08/2017

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Directions to “ EMILY MARIE WHITE OTRL” Practice Location

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