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NPI Code Detail

MEDICARE: AMBER M SHUTT MSOTR/L

MEDICARE: AMBER M SHUTT MSOTR/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 TherapistOC009716PA

General Provider Information

NPI Number : 1932387529
Entity Type Code : Individual
Provider Name (Legal Business Name) : AMBER M SHUTT MSOTR/L
Provider Business Mailing Address
First Line : 314 FAIRMONT DR
Second Line :
City : WATSONTOWN
State : PA
Zip : 17777-9413
Country : US
Telephone Number : 570-204-4066
Fax Number :
Provider Business Practice Location Address
First Line : 2140 WARRENSVILLE RD
Second Line :
City : MONTOURSVILLE
State : PA
Zip : 17754-9621
Country : US
Telephone Number : 570-433-3161
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/05/2008
Last Update Date : 02/05/2008

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