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NPI Code Detail

MEDICARE: MRS. BRANDALYN REGULA MOT, OTR/L

MEDICARE:  MRS. BRANDALYN  REGULA  MOT, OTR/L
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 Therapist007632OH

General Provider Information

NPI Number : 1891108049
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. BRANDALYN REGULA MOT, OTR/L
Provider Business Mailing Address
First Line : PO BOX 371
Second Line :
City : BALTIC
State : OH
Zip : 43804-0371
Country : US
Telephone Number : 330-897-9034
Fax Number :
Provider Business Practice Location Address
First Line : 834 E HIGH AVE
Second Line :
City : NEW PHILADELPHIA
State : OH
Zip : 44663-3052
Country : US
Telephone Number : 330-308-9939
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/05/2014
Last Update Date : 06/05/2014

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Directions to “ MRS. BRANDALYN REGULA MOT, OTR/L” Practice Location

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