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NPI Code Detail

MEDICARE: STEPHEN KAMBO OT

MEDICARE:   STEPHEN  KAMBO  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 Therapist31002174AIN

General Provider Information

NPI Number : 1821153370
Entity Type Code : Individual
Provider Name (Legal Business Name) : STEPHEN KAMBO OT
Provider Business Mailing Address
First Line : 1709 N WALNUT ST
Second Line :
City : HARTFORD CITY
State : IN
Zip : 47348-1359
Country : US
Telephone Number : 765-348-4197
Fax Number : 765-348-9627
Provider Business Practice Location Address
First Line : 1709 N WALNUT ST
Second Line :
City : HARTFORD CITY
State : IN
Zip : 47348-1359
Country : US
Telephone Number : 765-348-4197
Fax Number : 765-348-9627
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/26/2006
Last Update Date : 07/08/2007

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Directions to “ STEPHEN KAMBO OT” Practice Location

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