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NPI Code Detail

MEDICARE: DARION MURDOCK COTA/L

MEDICARE: DARION MURDOCK COTA/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
1224Z00000XOccupational Therapy AssistantOTA.0000861CO

General Provider Information

NPI Number : 1063922003
Entity Type Code : Individual
Provider Name (Legal Business Name) : DARION MURDOCK COTA/L
Provider Business Mailing Address
First Line : 46 PARK AVE APT 4
Second Line :
City : MANITOU SPRINGS
State : CO
Zip : 80829-1761
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 5446 N ACADEMY BLVD
Second Line :
City : COLORADO SPRINGS
State : CO
Zip : 80918-3644
Country : US
Telephone Number : 719-598-5555
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/04/2017
Last Update Date : 10/04/2017

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Directions to “ DARION MURDOCK COTA/L” Practice Location

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