MEDICARE: MS. ELEANOR LUCY CHRISTMAN OTR, 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	225XH1200X	Hand Occupational Therapist	OT9182	FL

General Provider Information

NPI Number	:	1992910178
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. ELEANOR LUCY CHRISTMAN OTR, CHT

Provider Business Mailing Address
First Line	:	1105 GOLFVIEW DR
Second Line	:
City	:	DAYTONA BEACH
State	:	FL
Zip	:	32114-5925
Country	:	US
Telephone Number	:	386-255-6966
Fax Number	:

Provider Business Practice Location Address
First Line	:	401 VENTURE DR
Second Line	:	SUITE C
City	:	SOUTH DAYTONA
State	:	FL
Zip	:	32119-3478
Country	:	US
Telephone Number	:	386-763-0084
Fax Number	:	386-763-0084

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

Provider Enumeration Date	:	05/11/2007
Last Update Date	:	03/20/2013

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