Mrs Mary Michelle Tallman, OTR/L | |
400 Rounds Dr, Fenton, MI 48430-1724 | |
(810) 629-0530 | |
Not Available |
Full Name | Mrs Mary Michelle Tallman |
---|---|
Gender | Female |
Speciality | Occupational Therapist - Pediatrics |
Location | 400 Rounds Dr, Fenton, Michigan |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1922405182 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
225XP0200X | Occupational Therapist - Pediatrics | 5201003934 (Michigan) | Primary |
Provider Name | Ivyrehab Michigan Llc |
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Provider Type | Part B Supplier - Physical/occupational Therapy Group In Private Practice |
Provider Identifiers | NPI Number: 1104337120 PECOS PAC ID: 6901165893 Enrollment ID: O20180123001245 |
Mailing Address | Practice Location Address |
---|---|
Mrs Mary Michelle Tallman, OTR/L 1311 Mamaroneck Ave Ste 140, White Plains, NY 10605-5224 Ph: (914) 265-4838 | Mrs Mary Michelle Tallman, OTR/L 400 Rounds Dr, Fenton, MI 48430-1724 Ph: (810) 629-0530 |
Kathryn Claypool, Occupational Therapist Medicare: Not Enrolled in Medicare Practice Location: 901 Pinecreek Dr, Fenton, MI 48430 Phone: 248-229-5731 | |
Brianna Rae Byrd, OT Occupational Therapist Medicare: Not Enrolled in Medicare Practice Location: 400 Rounds Dr, Fenton, MI 48430 Phone: 810-629-0530 Fax: 810-750-6361 | |
Ms. Kathleen Carey Haines, OTR/L Occupational Therapist Medicare: Not Enrolled in Medicare Practice Location: 700 Briarwood Ln, Fenton, MI 48430 Phone: 810-629-9032 | |
Ms. Anna Leigh Koontz, OTRL Occupational Therapist Medicare: Not Enrolled in Medicare Practice Location: 512 Beach St, Fenton, MI 48430 Phone: 810-629-4117 | |
Sarah Marie Brubaker, OT Occupational Therapist Medicare: Not Enrolled in Medicare Practice Location: 400 Rounds Dr, Fenton, MI 48430 Phone: 810-629-0530 | |
Jenna Ann Mandernach, OTRL Occupational Therapist Medicare: Medicare Enrolled Practice Location: 400 Rounds Dr, Fenton, MI 48430 Phone: 810-629-0530 | |
Patricia Ann Lee, Occupational Therapist Medicare: Not Enrolled in Medicare Practice Location: 17600 Silver Pkwy, Fenton, MI 48430 Phone: 810-449-9223 |