MEDICARE: KAREN C DWIRE 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	OT.0002549	CO
2	225X00000X	Occupational Therapist	8935	CA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	1060444	OTHER		NBCOT CERTIFICATION
2	OT.0002549	OTHER	CO	OT LICENSE
3	8935	OTHER	CA	OT LICENSE

General Provider Information

NPI Number	:	1851442370
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KAREN C DWIRE OTR

Provider Business Mailing Address
First Line	:	7 COLOMBARD CT
Second Line	:
City	:	GRAND JUNCTION
State	:	CO
Zip	:	81507-1251
Country	:	US
Telephone Number	:	970-314-0351
Fax Number	:

Provider Business Practice Location Address
First Line	:	7 COLOMBARD CT
Second Line	:
City	:	GRAND JUNCTION
State	:	CO
Zip	:	81507-1251
Country	:	US
Telephone Number	:	970-314-0351
Fax Number	:

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

Provider Enumeration Date	:	01/12/2007
Last Update Date	:	09/08/2021

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