MEDICARE: NATALIE MARIE TARBUTTON OT

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	17-02914	KS

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	17-02914	OTHER	KS	LICENSE OT

General Provider Information

NPI Number	:	1942602800
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	NATALIE MARIE TARBUTTON OT

Provider Business Mailing Address
First Line	:	3901 RAINBOW BLVD
Second Line	:
City	:	KANSAS CITY
State	:	KS
Zip	:	66160-7389
Country	:	US
Telephone Number	:	913-588-4375
Fax Number	:	913-588-1660

Provider Business Practice Location Address
First Line	:	3901 RAINBOW BLVD
Second Line	:
City	:	KANSAS CITY
State	:	KS
Zip	:	66160-7389
Country	:	US
Telephone Number	:	913-588-4375
Fax Number	:	913-588-1660

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

Provider Enumeration Date	:	09/23/2014
Last Update Date	:	09/23/2014

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