Individual
LARRY SCOTT MADDY
Active
Individual
LARRY SCOTT MADDY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
OTR L CHT
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
1145
NC
225XH1200X
Hand Occupational Therapist
9105000708
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2510062C
MEDICARE OCCUPATIONAL THERAPY
NC
01
—
53709
BCBS
NC
01
—
66985
MEDCOST
—
01
—
670000776
MEDICARE RAILROAD
NC
05
—
7301040
—
NC
Enumeration date
11/10/2005
Last updated
06/16/2014
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