MEDICARE: MRS. MARIANNE TOTTON 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	5201005992	MI

General Provider Information

NPI Number	:	1518236868
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. MARIANNE TOTTON OTR/L

Provider Business Mailing Address
First Line	:	5485 S RIVERVIEW DR
Second Line	:
City	:	LAKE CITY
State	:	MI
Zip	:	49651-8656
Country	:	US
Telephone Number	:	231-839-4523
Fax Number	:

Provider Business Practice Location Address
First Line	:	5485 S RIVERVIEW DR
Second Line	:
City	:	LAKE CITY
State	:	MI
Zip	:	49651-8656
Country	:	US
Telephone Number	:	231-839-4523
Fax Number	:

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

Provider Enumeration Date	:	12/15/2011
Last Update Date	:	12/15/2011

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