MEDICARE: NANCY L STRUB OTR/L, CHT

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	0C000557	PA

General Provider Information

NPI Number	:	1891743738
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	NANCY L STRUB OTR/L, CHT

Provider Business Mailing Address
First Line	:	298 OLD FORGE XING
Second Line	:
City	:	DEVON
State	:	PA
Zip	:	19333-1122
Country	:	US
Telephone Number	:	610-688-2969
Fax Number	:

Provider Business Practice Location Address
First Line	:	744 W LANCASTER AVE
Second Line	:	STE. 125
City	:	WAYNE
State	:	PA
Zip	:	19087-2523
Country	:	US
Telephone Number	:	610-688-7776
Fax Number	:	610-688-4117

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

Provider Enumeration Date	:	05/04/2006
Last Update Date	:	07/08/2007

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