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NPI Code Detail

MEDICARE: PAULA MICHELLE HOLM OTR, MS

MEDICARE: PAULA MICHELLE HOLM OTR, MS
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 Therapist2016028296MO
2225X00000XOccupational Therapist17-03226KS

General Provider Information

NPI Number : 1871035683
Entity Type Code : Individual
Provider Name (Legal Business Name) : PAULA MICHELLE HOLM OTR, MS
Provider Business Mailing Address
First Line : 8823 PRODUCTION LN
Second Line :
City : OOLTEWAH
State : TN
Zip : 37363-6511
Country : US
Telephone Number : 423-238-7217
Fax Number : 423-238-3473
Provider Business Practice Location Address
First Line : 3355 MAIN ST
Second Line :
City : KANSAS CITY
State : MO
Zip : 64111-1904
Country : US
Telephone Number : 816-399-4640
Fax Number : 816-743-7413
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/10/2016
Last Update Date : 11/10/2016

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