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NPI Code Detail

MEDICARE: TIMOTHY BOLEWICZ OTR

MEDICARE: TIMOTHY BOLEWICZ OTR
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
1225X00000XOccupational Therapist9MT

General Provider Information

NPI Number : 1093059313
Entity Type Code : Individual
Provider Name (Legal Business Name) : TIMOTHY BOLEWICZ OTR
Provider Business Mailing Address
First Line : 2400 CONTINENTAL DR
Second Line :
City : BUTTE
State : MT
Zip : 59701-6563
Country : US
Telephone Number : 406-723-6556
Fax Number :
Provider Business Practice Location Address
First Line : 2400 CONTINENTAL DR
Second Line :
City : BUTTE
State : MT
Zip : 59701-6563
Country : US
Telephone Number : 406-723-6556
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/27/2012
Last Update Date : 11/27/2012

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Directions to “ TIMOTHY BOLEWICZ OTR” Practice Location

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