Stephen Kambo, OT

Individual provider Active NPI Occupational Therapist · Hartford City, IN

NPI 1821153370 · NPPES record last updated Jul 8, 2007

Key facts

NPI
1821153370
Entity type
Individual (NPI type 1)
Primary specialty
Occupational Therapist 225X00000X
License
31002174A (IN)
Practice address
1709 N Walnut St
Hartford City, IN 47348-1359
Phone
(765) 348-4197
Fax
(765) 348-9627
NPI assigned
Dec 26, 2006
Sex
Male
Sole proprietor
No

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
31002174AINMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Midwest Healthstrategies, Inc. Past Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X 31002174A IN Yes

Addresses

Primary practice location

1709 N Walnut St
Hartford City, IN 47348-1359

Mailing address

1709 N Walnut St
Hartford City, IN 47348-1359
Phone (765) 348-4197

Other providers in Hartford City, IN

All providers in Hartford City, IN · Occupational Therapist in Indiana

Sources for this page

Verify at the official NPI Registry.