Provider Demographics
NPI:1609245158
Name:OCCUPRO, LLC
Entity Type:Organization
Organization Name:OCCUPRO, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SENIOR VICE PRESIDENT OF SALES/OWNE
Authorized Official - Prefix:MR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:
Authorized Official - Last Name:MECHAM
Authorized Official - Suffix:
Authorized Official - Credentials:MSIE, OTR/L, CPE
Authorized Official - Phone:866-470-4440
Mailing Address - Street 1:3921 30TH AVE
Mailing Address - Street 2:
Mailing Address - City:KENOSHA
Mailing Address - State:WI
Mailing Address - Zip Code:53144-1957
Mailing Address - Country:US
Mailing Address - Phone:866-470-4440
Mailing Address - Fax:866-520-5557
Practice Address - Street 1:3921 30TH AVE
Practice Address - Street 2:
Practice Address - City:KENOSHA
Practice Address - State:WI
Practice Address - Zip Code:53144-1957
Practice Address - Country:US
Practice Address - Phone:866-470-4440
Practice Address - Fax:866-520-5557
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-09-15
Last Update Date:2015-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Single Specialty