Healthcare Provider Details

I. General information

NPI: 1477119782
Provider Name (Legal Business Name): JEREMY DAVID KUGLER OTR/L
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/13/2019
Last Update Date: 05/13/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

600 S 27TH ST
BILLINGS MT
59101-4508
US

IV. Provider business mailing address

3828 KATY LN
BILLINGS MT
59101-6187
US

V. Phone/Fax

Practice location:
  • Phone: 406-259-8000
  • Fax:
Mailing address:
  • Phone: 406-208-0337
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License NumberOTP-OT-LIC-6323
License Number StateMT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: