=====================================================
General NPI Number Information
=====================================================
NPI Number | 1821227356
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | INTEGRATED OCCUPATIONAL THERAPY SERVICES, LLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 07/06/2009
-----------------------------------------------------
Last Update Date | 04/18/2017
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 5251 COUNTRY SQUIRE WAY
-----------------------------------------------------
City | FORT COLLINS
-----------------------------------------------------
State | CO
-----------------------------------------------------
Zip | 80528-9619
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 970-217-7302
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 5251 COUNTRY SQUIRE WAY
-----------------------------------------------------
City | FORT COLLINS
-----------------------------------------------------
State | CO
-----------------------------------------------------
Zip | 80528-9619
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 970-217-7302
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | PRESIDENT
-----------------------------------------------------
Name | EILEEN L GETCHES
-----------------------------------------------------
Credential | OTR
-----------------------------------------------------
Telephone | 970-217-7302
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 225X00000X
-----------------------------------------------------
Taxonomy Name | Occupational Therapist
-----------------------------------------------------
License Number | 1624
-----------------------------------------------------
License Number State | CO
-----------------------------------------------------