MEDICARE: ANNA PEYTON MOT, OTR

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

General Provider Information

NPI Number	:	1780225896
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ANNA PEYTON MOT, OTR

Provider Business Mailing Address
First Line	:	2812 TRENTON WAY
Second Line	:
City	:	FORT COLLINS
State	:	CO
Zip	:	80526-2298
Country	:	US
Telephone Number	:	970-405-3672
Fax Number	:

Provider Business Practice Location Address
First Line	:	2812 TRENTON WAY
Second Line	:
City	:	FORT COLLINS
State	:	CO
Zip	:	80526-2298
Country	:	US
Telephone Number	:	970-405-3672
Fax Number	:

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

Provider Enumeration Date	:	10/01/2019
Last Update Date	:	10/01/2019

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