MEDICARE: ALEXIA WALTZ 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
1	225X00000X	Occupational Therapist	897726	WI

General Provider Information

NPI Number	:	1447137799
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ALEXIA WALTZ OTR/L

Provider Business Mailing Address
First Line	:	PO BOX 860912
Second Line	:
City	:	MINNEAPOLIS
State	:	MN
Zip	:	55486-0912
Country	:	US
Telephone Number	:	507-284-2511
Fax Number	:

Provider Business Practice Location Address
First Line	:	403 N MAPLE ST
Second Line	:
City	:	ELLSWORTH
State	:	WI
Zip	:	54011-9037
Country	:	US
Telephone Number	:	715-273-5821
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/19/2025
Last Update Date	:	10/21/2025

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