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NPI Code Detail

MEDICARE: KRISTEN D. BREIMAYER MOT, OTR/L

MEDICARE:   KRISTEN D. BREIMAYER  MOT, 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
1225X00000XOccupational Therapist5201006794MI

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
230435OTHERMIBLUE CROSS BLUE SHIELD

General Provider Information

NPI Number : 1235323767
Entity Type Code : Individual
Provider Name (Legal Business Name) : KRISTEN D. BREIMAYER MOT, OTR/L
Provider Business Mailing Address
First Line : 6604 BELLA VISTA DR NE
Second Line :
City : ROCKFORD
State : MI
Zip : 49341-8441
Country : US
Telephone Number : 734-748-7144
Fax Number : 734-748-7144
Provider Business Practice Location Address
First Line : 2251 EAST PARIS AVE SE
Second Line :
City : GRAND RAPIDS
State : MI
Zip : 49546-2431
Country : US
Telephone Number : 616-447-7799
Fax Number : 616-447-7799
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/28/2007
Last Update Date : 02/25/2015

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Directions to “ KRISTEN D. BREIMAYER MOT, OTR/L” Practice Location

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