MEDICARE: AMY BETH WESTBROCK OTR/L, MBA

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

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1699947325
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	AMY BETH WESTBROCK OTR/L, MBA

Provider Business Mailing Address
First Line	:	415 36TH ST
Second Line	:	SUITE 100
City	:	PARKERSBURG
State	:	WV
Zip	:	26101-1005
Country	:	US
Telephone Number	:	304-917-3660
Fax Number	:	304-917-3674

Provider Business Practice Location Address
First Line	:	2010 GARFIELD AVE
Second Line	:	SUITE 2
City	:	PARKERSBURG
State	:	WV
Zip	:	26101-2527
Country	:	US
Telephone Number	:	304-917-3649
Fax Number	:	304-917-3651

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

Provider Enumeration Date	:	04/02/2008
Last Update Date	:	05/27/2016

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