MEDICARE: RANDY VANHULTEN 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
1	225X00000X	Occupational Therapist	OC003939-L	PA
2	225X00000X	Occupational Therapist	OC003939L	PA

General Provider Information

NPI Number	:	1811951254
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	RANDY VANHULTEN OTR

Provider Business Mailing Address
First Line	:	1440 PERRI DR
Second Line	:
City	:	PITTSBURGH
State	:	PA
Zip	:	15226-2519
Country	:	US
Telephone Number	:	412-680-0058
Fax Number	:

Provider Business Practice Location Address
First Line	:	969 GREENTREE ROAD
Second Line	:	SUITE 170
City	:	PITTSBURGH
State	:	PA
Zip	:	15220-3328
Country	:	US
Telephone Number	:	412-922-3344
Fax Number	:	412-922-8488

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

Provider Enumeration Date	:	04/13/2006
Last Update Date	:	01/31/2023

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