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NPI Code Detail

MEDICARE: MARIA F GALLUCCI C.O.T.A.

MEDICARE: MARIA F GALLUCCI C.O.T.A.
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
1224Z00000XOccupational Therapy Assistant989535CO

General Provider Information

NPI Number : 1477898971
Entity Type Code : Individual
Provider Name (Legal Business Name) : MARIA F GALLUCCI C.O.T.A.
Provider Business Mailing Address
First Line : 1005 E ELIZABETH ST
Second Line :
City : FORT COLLINS
State : CO
Zip : 80524-3911
Country : US
Telephone Number : 970-482-2525
Fax Number :
Provider Business Practice Location Address
First Line : 1005 E ELIZABETH ST
Second Line :
City : FORT COLLINS
State : CO
Zip : 80524-3911
Country : US
Telephone Number : 970-482-2525
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/10/2012
Last Update Date : 12/10/2012

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