MEDICARE: PINWHEELS AND PUDDLES LLC

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

General Provider Information

NPI Number	:	1184551624
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PINWHEELS AND PUDDLES LLC

Provider Business Mailing Address
First Line	:	3001 NINEBARK DR
Second Line	:
City	:	FORT COLLINS
State	:	CO
Zip	:	80528-8503
Country	:	US
Telephone Number	:	970-658-5058
Fax Number	:

Provider Business Practice Location Address
First Line	:	3001 NINEBARK DR
Second Line	:
City	:	FORT COLLINS
State	:	CO
Zip	:	80528-8503
Country	:	US
Telephone Number	:	970-658-5058
Fax Number	:

Authorized Official
Title or Position	:	OCCUPATIONAL THERAPIST
Name	:	JENNIFER AGULNEK
Credential	:	MA, OTR/L
Telephone Number	:	970-658-5058

Provider Enumeration Date	:	05/07/2026
Last Update Date	:	05/07/2026

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