MEDICARE: MR. NORMAN RANDALL CARTER 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	225X00000X	Occupational Therapist	2647	TN

General Provider Information

NPI Number	:	1760568380
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. NORMAN RANDALL CARTER OTR/L

Provider Business Mailing Address
First Line	:	4021 CLINTON LN
Second Line	:
City	:	SPRING HILL
State	:	TN
Zip	:	37174-7441
Country	:	US
Telephone Number	:	615-302-1365
Fax Number	:

Provider Business Practice Location Address
First Line	:	202 E MTCS RD
Second Line	:
City	:	MURFREESBORO
State	:	TN
Zip	:	37129-1524
Country	:	US
Telephone Number	:	615-849-8748
Fax Number	:

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

Provider Enumeration Date	:	10/27/2006
Last Update Date	:	07/08/2007

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