MEDICARE: MRS. KRISTIE ANN ARMSTRONG 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	669	NE

General Provider Information

NPI Number	:	1689850240
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. KRISTIE ANN ARMSTRONG COTA/L

Provider Business Mailing Address
First Line	:	2434 33RD ST
Second Line	:
City	:	COLUMBUS
State	:	NE
Zip	:	68601-1856
Country	:	US
Telephone Number	:	402-564-3108
Fax Number	:

Provider Business Practice Location Address
First Line	:	2434 33RD ST
Second Line	:
City	:	COLUMBUS
State	:	NE
Zip	:	68601-1856
Country	:	US
Telephone Number	:	402-564-3108
Fax Number	:

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

Provider Enumeration Date	:	01/14/2008
Last Update Date	:	01/14/2008

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