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NPI Code Detail

MEDICARE: OLGA MANGUSHEVA OTR

MEDICARE: OLGA MANGUSHEVA OTR
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 Therapist31005231AIN

General Provider Information

NPI Number : 1700156221
Entity Type Code : Individual
Provider Name (Legal Business Name) : OLGA MANGUSHEVA OTR
Provider Business Mailing Address
First Line : 9919 TOWNE RD
Second Line :
City : CARMEL
State : IN
Zip : 46032-8260
Country : US
Telephone Number : 317-872-4166
Fax Number :
Provider Business Practice Location Address
First Line : 9919 TOWNE RD
Second Line :
City : CARMEL
State : IN
Zip : 46032-8260
Country : US
Telephone Number : 317-872-4166
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/02/2012
Last Update Date : 01/02/2012

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Directions to “ OLGA MANGUSHEVA OTR” Practice Location

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