Basic Information
Provider Information
NPI: 1023223245
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: INAMURA
FirstName: KATHERINE
MiddleName:  
NamePrefix: MRS.
NameSuffix:  
Credential: OTR
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 6171 HUNTLEY RD
Address2: SUITE E
City: COLUMBUS
State: OH
PostalCode: 432291079
CountryCode: US
TelephoneNumber: 6148400558
FaxNumber: 6148409310
Practice Location
Address1: 6171 HUNTLEY RD
Address2: SUITE E
City: COLUMBUS
State: OH
PostalCode: 432291079
CountryCode: US
TelephoneNumber: 6148400558
FaxNumber: 6148409310
Other Information
ProviderEnumerationDate: 05/11/2007
LastUpdateDate: 07/08/2007
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
225X00000XOT-05142OHY Respiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist 

No ID Information.


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