MEDICARE: MRS. AMY L RIENTS COTA/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	224Z00000X	Occupational Therapy Assistant	202643	MN

General Provider Information

NPI Number	:	1548913692
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. AMY L RIENTS COTA/L

Provider Business Mailing Address
First Line	:	1005 CENTURY CT
Second Line	:
City	:	BELLE PLAINE
State	:	MN
Zip	:	56011-2085
Country	:	US
Telephone Number	:	952-484-7224
Fax Number	:

Provider Business Practice Location Address
First Line	:	8100 HIGHWOOD DR
Second Line	:
City	:	BLOOMINGTON
State	:	MN
Zip	:	55438-1079
Country	:	US
Telephone Number	:	952-831-7500
Fax Number	:

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

Provider Enumeration Date	:	01/29/2022
Last Update Date	:	01/29/2022

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