DEEPIKA MEDAVARAM

Occupational Therapy Assistant

Active Individual
NPI: 1053567891

Practice Address

3400 W WASHINGTON ST
Springfield, IL 62711

Phone: (217) 787-9600

Specialties

Specialty Code Primary License
Occupational Therapy Assistant 224Z00000X Yes 057001007 (IL)

Frequently Asked Questions

NPI 1053567891 is the National Provider Identifier for DEEPIKA MEDAVARAM, a Occupational Therapy Assistant provider located in Springfield, IL. This NPI was enumerated on August 12, 2008.
DEEPIKA MEDAVARAM practices at 3400 W WASHINGTON ST, Springfield, IL 62711.

Quick Facts

NPI
1053567891
Type
Individual
Enumerated
Aug 12, 2008
Last Updated
Aug 12, 2008

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