| Dr Justin Oran Mcdivitt, OTD, R/L | |
| 815 S Walnut Ave, Cookeville, TN 38501-5956 | |
| (931) 646-7216 | |
| Not Available | 
| Full Name | Dr Justin Oran Mcdivitt | 
|---|---|
| Gender | Male | 
| Speciality | Occupational Therapist | 
| Location | 815 S Walnut Ave, Cookeville, Tennessee | 
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. | 
| Identifier | Type | State | Issuer | 
|---|---|---|---|
| 1053613802 | NPI | - | NPPES | 
| Taxonomy | Type | License (State) | Status | 
|---|---|---|---|
| 225X00000X | Occupational Therapist | 4071 (Tennessee) | Primary | 
| Provider Name | Healthpro Heritage Rehab & Fitness Llc | 
|---|---|
| Provider Type | Part B Supplier - Clinic/group Practice | 
| Provider Identifiers | NPI Number: 1376073262 PECOS PAC ID: 6507832573 Enrollment ID: O20171003005084 | 
| Mailing Address | Practice Location Address | 
|---|---|
| Dr Justin Oran Mcdivitt, OTD, R/L 952 Nottingham Dr, Cookeville, TN 38506-4310 Ph: () - | Dr Justin Oran Mcdivitt, OTD, R/L 815 S Walnut Ave, Cookeville, TN 38501-5956 Ph: (931) 646-7216 | 
| Jayne Guy, OTR Occupational Therapist Medicare: Not Enrolled in Medicare Practice Location: 2370 Quinland Lake Rd Ste 150, Cookeville, TN 38506 Phone: 931-201-9472 | |
| Wee Talk, Llc Occupational Therapist Medicare: Not Enrolled in Medicare Practice Location: 1615 Brown Ave, Suite 2a, Cookeville, TN 38501 Phone: 931-261-8007 | |
| Rachel Macmillan, OTR/L Occupational Therapist Medicare: Accepting Medicare Assignments Practice Location: 1 Medical Center Blvd, Cookeville, TN 38501 Phone: 931-528-2541 | |
| Craig Dunford, OT Occupational Therapist Medicare: Not Enrolled in Medicare Practice Location: 370 S Lowe Ave Ste A330, Cookeville, TN 38501 Phone: 606-224-6915 | |
| Mr. Jon Michael Allen, OTRL Occupational Therapist Medicare: Medicare Enrolled Practice Location: 748 Chestnut Ave, Apt 1-c, Cookeville, TN 38501 Phone: 606-224-6915 | |
| Anna Jill Mcdermott, OTR/L Occupational Therapist Medicare: Not Enrolled in Medicare Practice Location: 815 S Walnut Ave, Cookeville, TN 38501 Phone: 931-528-5516 |