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NPI Code Detail

MEDICARE: SUSAN STAHL OT

MEDICARE: SUSAN STAHL OT
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 Therapist1700300KS

General Provider Information

NPI Number : 1700881828
Entity Type Code : Individual
Provider Name (Legal Business Name) : SUSAN STAHL OT
Provider Business Mailing Address
First Line : 1305 WAKARUSA DR
Second Line :
City : LAWRENCE
State : KS
Zip : 66049-3830
Country : US
Telephone Number : 785-842-3444
Fax Number : 785-842-3410
Provider Business Practice Location Address
First Line : 1305 WAKARUSA DR
Second Line :
City : LAWRENCE
State : KS
Zip : 66049-3830
Country : US
Telephone Number : 785-842-3444
Fax Number : 785-842-3410
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/15/2005
Last Update Date : 01/03/2024

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Directions to “ SUSAN STAHL OT” Practice Location

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