MEDICARE: EMMA CHAMBERS 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	174400000X	Specialist	341	SC

General Provider Information

NPI Number	:	1699170084
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	EMMA CHAMBERS OTR/L

Provider Business Mailing Address
First Line	:	2059 WILD FLOWER LN
Second Line	:
City	:	CHARLESTON
State	:	SC
Zip	:	29414-6471
Country	:	US
Telephone Number	:	843-729-8977
Fax Number	:

Provider Business Practice Location Address
First Line	:	2059 WILD FLOWER LN
Second Line	:
City	:	CHARLESTON
State	:	SC
Zip	:	29414-6471
Country	:	US
Telephone Number	:	843-729-8977
Fax Number	:

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

Provider Enumeration Date	:	10/28/2014
Last Update Date	:	10/28/2014

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