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NPI Code Detail

MEDICARE: HEIDI SUE CAVAGNETTO OTR

MEDICARE:   HEIDI SUE CAVAGNETTO  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 Therapist102466MN

General Provider Information

NPI Number : 1275693301
Entity Type Code : Individual
Provider Name (Legal Business Name) : HEIDI SUE CAVAGNETTO OTR
Provider Business Mailing Address
First Line : 400 E THIRD STREET
Second Line : SSB-5
City : DULUTH
State : MN
Zip : 55805-1951
Country : US
Telephone Number : 320-245-2211
Fax Number :
Provider Business Practice Location Address
First Line : 705 LUNDORFF DR
Second Line :
City : SANDSTONE
State : MN
Zip : 55072-5099
Country : US
Telephone Number : 320-245-2211
Fax Number : 320-245-2359
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/11/2006
Last Update Date : 10/13/2020

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Directions to “ HEIDI SUE CAVAGNETTO OTR” Practice Location

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