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NPI Code Detail

MEDICARE: STACY TWEDT COTA/L

MEDICARE: STACY TWEDT 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
1224Z00000XOccupational Therapy Assistant799NE

General Provider Information

NPI Number : 1710378476
Entity Type Code : Individual
Provider Name (Legal Business Name) : STACY TWEDT COTA/L
Provider Business Mailing Address
First Line : 2720 17TH AVE
Second Line :
City : CENTRAL CITY
State : NE
Zip : 68826-9614
Country : US
Telephone Number : 308-946-3088
Fax Number :
Provider Business Practice Location Address
First Line : 2720 17TH AVE
Second Line :
City : CENTRAL CITY
State : NE
Zip : 68826-9614
Country : US
Telephone Number : 308-946-3088
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/16/2015
Last Update Date : 02/16/2015

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Directions to “ STACY TWEDT COTA/L” Practice Location

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