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General NPI Number Information
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NPI Number | 1699212605
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Entity Type | Individual
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Provider Name | PEGGY BORDERS OTR
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Gender | Female
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Dates
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Enumeration Date | 01/27/2017
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Last Update Date | 01/27/2017
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Provider Practice Location Address
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Address Line | 800 E 28TH ST
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City | MINNEAPOLIS
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State | MN
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Zip | 55407-3723
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Country | US
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Telephone | 612-262-1166
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Fax |
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Provider Business Mailing Address
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Address Line | 5337 IMHOFF AVE SW
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City | HOWARD LAKE
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State | MN
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Zip | 55349-5207
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Country | US
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Telephone | 218-330-1303
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225X00000X
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Taxonomy Name | Occupational Therapist
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License Number | 100251
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License Number State | MN
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