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NPI Code Detail

MEDICARE: DR. ELICIA DUNN CRUZ PHD, OTR

MEDICARE:  DR. ELICIA DUNN CRUZ  PHD, 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 Therapist3882TN

General Provider Information

NPI Number : 1760648893
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. ELICIA DUNN CRUZ PHD, OTR
Provider Business Mailing Address
First Line : 1486 MORRIS HILL ROAD
Second Line :
City : CHATTANOOGA
State : TN
Zip : 37421
Country : US
Telephone Number : 423-475-5342
Fax Number :
Provider Business Practice Location Address
First Line : 1204 FRYE ST
Second Line :
City : ATHENS
State : TN
Zip : 37303-3052
Country : US
Telephone Number : 423-475-0434
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/29/2008
Last Update Date : 07/29/2008

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Directions to “ DR. ELICIA DUNN CRUZ PHD, OTR” Practice Location

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