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NPI Code Detail

MEDICARE: TERESA STOKER

MEDICARE:   TERESA  STOKER
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 Therapist
2224Z00000XOccupational Therapy AssistantOTA001212GA

General Provider Information

NPI Number : 1871051953
Entity Type Code : Individual
Provider Name (Legal Business Name) : TERESA STOKER
Provider Business Mailing Address
First Line : 110 PARK CITY RD
Second Line :
City : ROSSVILLE
State : GA
Zip : 30741-3980
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 110 PARK CITY RD
Second Line :
City : ROSSVILLE
State : GA
Zip : 30741-3980
Country : US
Telephone Number : 706-858-2702
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/07/2019
Last Update Date : 03/07/2019

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Directions to “ TERESA STOKER ” Practice Location

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