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NPI Code Detail

MEDICARE: TREENA RADERMACHER OT

MEDICARE: TREENA RADERMACHER OT
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1225X00000XOccupational Therapist619ND

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1093744377
Entity Type Code : Individual
Provider Name (Legal Business Name) : TREENA RADERMACHER OT
Provider Business Mailing Address
First Line : 11 NORTH MAIN ST
Second Line :
City : GWINNER
State : ND
Zip : 58040-0586
Country : US
Telephone Number : 701-678-2244
Fax Number : 701-678-2210
Provider Business Practice Location Address
First Line : 11 NORTH MAIN ST
Second Line :
City : GWINNER
State : ND
Zip : 58040-0586
Country : US
Telephone Number : 701-678-2244
Fax Number : 701-678-2210
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/30/2006
Last Update Date : 02/22/2017

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Directions to “ TREENA RADERMACHER OT” Practice Location

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