MEDICARE: MRS. PATRICE POWER VOLKENS M.O.T

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	003403	OH

General Provider Information

NPI Number	:	1760508576
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. PATRICE POWER VOLKENS M.O.T

Provider Business Mailing Address
First Line	:	6958 CRANBROOK DR
Second Line	:
City	:	BRECKSVILLE
State	:	OH
Zip	:	44141-2764
Country	:	US
Telephone Number	:	440-838-1571
Fax Number	:	440-838-1573

Provider Business Practice Location Address
First Line	:	7000 TOWN CENTRE DR STE 400
Second Line	:
City	:	BROADVIEW HEIGHTS
State	:	OH
Zip	:	44147-4008
Country	:	US
Telephone Number	:	440-526-8566
Fax Number	:

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

Provider Enumeration Date	:	03/22/2007
Last Update Date	:	07/08/2007

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