MEDICARE: MRS. BETH ANN SALISBURY OTR/L

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	003512	OH
2	225X00000X	Occupational Therapist	31001760A	IN

General Provider Information

NPI Number	:	1679528004
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. BETH ANN SALISBURY OTR/L

Provider Business Mailing Address
First Line	:	4247 PRICES CREEK RD
Second Line	:
City	:	LEWISBURG
State	:	OH
Zip	:	45338-8055
Country	:	US
Telephone Number	:	937-962-9427
Fax Number	:

Provider Business Practice Location Address
First Line	:	4247 PRICES CREEK RD
Second Line	:
City	:	LEWISBURG
State	:	OH
Zip	:	45338-8055
Country	:	US
Telephone Number	:	937-938-0826
Fax Number	:	800-708-6150

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

Provider Enumeration Date	:	05/24/2006
Last Update Date	:	12/14/2015

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