Provider Demographics
NPI:1598829624
Name:HUNTER, ELIZABETH (MOT, OTR/L)
Entity Type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:
Last Name:HUNTER
Suffix:
Gender:F
Credentials:MOT, OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1377 11TH ST NW
Mailing Address - Street 2:
Mailing Address - City:CLINTON
Mailing Address - State:IA
Mailing Address - Zip Code:52732-5068
Mailing Address - Country:US
Mailing Address - Phone:563-241-4230
Mailing Address - Fax:563-241-4233
Practice Address - Street 1:1377 11TH ST NW
Practice Address - Street 2:
Practice Address - City:CLINTON
Practice Address - State:IA
Practice Address - Zip Code:52732-5068
Practice Address - Country:US
Practice Address - Phone:563-241-4230
Practice Address - Fax:563-241-4233
Is Sole Proprietor?:No
Enumeration Date:2006-12-21
Last Update Date:2007-12-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA01793225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA29935OtherBLUE CROSS BLUE SHIELD
IAI18976OtherMEDICARE
IA0665711Medicaid
IAI18976OtherMEDICARE