Provider Demographics
NPI:1730344565
Name:BARTZ, MARY (OTR)
Entity type:Individual
Prefix:MRS
First Name:MARY
Middle Name:
Last Name:BARTZ
Suffix:
Gender:F
Credentials:OTR
Other - Prefix:
Other - First Name:MARY
Other - Middle Name:
Other - Last Name:FLARIS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:6080 W 117TH AVE
Mailing Address - Street 2:
Mailing Address - City:CROWN POINT
Mailing Address - State:IN
Mailing Address - Zip Code:46307-8789
Mailing Address - Country:US
Mailing Address - Phone:219-663-6392
Mailing Address - Fax:219-663-3529
Practice Address - Street 1:6685 E 117TH AVE
Practice Address - Street 2:
Practice Address - City:CROWN POINT
Practice Address - State:IN
Practice Address - Zip Code:46307-7808
Practice Address - Country:US
Practice Address - Phone:219-663-6329
Practice Address - Fax:219-663-3529
Is Sole Proprietor?:No
Enumeration Date:2008-07-21
Last Update Date:2008-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN31001716A225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist