MEDICARE: MADISYN MORROW OTD, OTR/L

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225X00000X	Occupational Therapist	107643	MN

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	107643	OTHER	MN	OTR/L
2	8777-26	OTHER	WI	OTR/L
3	524089	OTHER		NBCOT

General Provider Information

NPI Number	:	1043011018
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MADISYN MORROW OTD, OTR/L

Provider Business Mailing Address
First Line	:	5860 BAKER RD
Second Line	:
City	:	MINNETONKA
State	:	MN
Zip	:	55345-5903
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	2101 ROLLING GREEN LN
Second Line	:
City	:	NORTH MANKATO
State	:	MN
Zip	:	56003-4442
Country	:	US
Telephone Number	:	507-225-8118
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/24/2025
Last Update Date	:	03/24/2025

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