Healthcare Provider Details

I. General information

NPI: 1033396544
Provider Name (Legal Business Name): EILEEN KASER OCCUPATIONAL THERAPI
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/28/2008
Last Update Date: 01/28/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

15355 6800 RD
MONTROSE CO
81401-7423
US

IV. Provider business mailing address

15355 6800 RD
MONTROSE CO
81401-7423
US

V. Phone/Fax

Practice location:
  • Phone: 970-249-2012
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number6791554-4201
License Number StateUT
# 2
Primary TaxonomyN
Taxonomy Code311Z00000X
TaxonomyCustodial Care Facility
License Number6791554-4201
License Number StateUT
# 3
Primary TaxonomyN
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number6791554-4201
License Number StateUT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: