Healthcare Provider Details

I. General information

NPI: 1437554474
Provider Name (Legal Business Name): PEGGY ADAMS OTR/L
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/04/2014
Last Update Date: 11/04/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

418 S WEBER ST
COLORADO SPRINGS CO
80903-2127
US

IV. Provider business mailing address

418 S WEBER ST
COLORADO SPRINGS CO
80903-2127
US

V. Phone/Fax

Practice location:
  • Phone: 719-380-1100
  • Fax: 719-380-1108
Mailing address:
  • Phone: 719-380-1100
  • Fax: 719-380-1108

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License NumberOT4131
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: