MEDICARE: SUSAN BROWN TRUSTY OTR/L, CHT

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	4035	SC
2	225XP0019X	Physical Rehabilitation Occupational Therapist	3377	MT
3	225X00000X	Occupational Therapist	3377	MT
4	225X00000X	Occupational Therapist	3052	CO
5	225X00000X	Occupational Therapist		AL

General Provider Information

NPI Number	:	1538114251
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SUSAN BROWN TRUSTY OTR/L, CHT

Provider Business Mailing Address
First Line	:	790 REMINGTON BLVD
Second Line	:
City	:	BOLINGBROOK
State	:	IL
Zip	:	60440-4909
Country	:	US
Telephone Number	:	630-296-2223
Fax Number	:

Provider Business Practice Location Address
First Line	:	3406 LARAMIE DR
Second Line	:
City	:	BOZEMAN
State	:	MT
Zip	:	59718-2005
Country	:	US
Telephone Number	:	406-587-0122
Fax Number	:	844-656-2480

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

Provider Enumeration Date	:	05/23/2006
Last Update Date	:	04/08/2024

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