Healthcare Provider Details

I. General information

NPI: 1629569124
Provider Name (Legal Business Name): JOANNE M ZOTTI
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/21/2018
Last Update Date: 05/21/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1977 DEWAR DR STE J
ROCK SPRINGS WY
82901-5757
US

IV. Provider business mailing address

2613 SEATTLE SLEW DR
ROCK SPRINGS WY
82901-6699
US

V. Phone/Fax

Practice location:
  • Phone: 307-382-3228
  • Fax: 307-382-6886
Mailing address:
  • Phone: 307-382-3228
  • Fax: 307-382-6886

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License NumberOTR-164
License Number StateWY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: