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NPI Code Detail

MEDICARE: MS. BRANDI LEE BREITBACH OT, MOTR/L

MEDICARE: MS. BRANDI LEE BREITBACH OT, MOTR/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 Therapist908ND

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1467572214
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. BRANDI LEE BREITBACH OT, MOTR/L
Provider Business Mailing Address
First Line : 2625 N 19TH ST
Second Line :
City : BISMARCK
State : ND
Zip : 58503-0574
Country : US
Telephone Number : 701-214-5578
Fax Number :
Provider Business Practice Location Address
First Line : 2625 N 19TH ST
Second Line :
City : BISMARCK
State : ND
Zip : 58503-0574
Country : US
Telephone Number : 701-214-5578
Fax Number : 701-222-3186
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/29/2007
Last Update Date : 12/18/2024

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