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NPI Code Detail

MEDICARE: KARA C LA GRANDE OTR/L

MEDICARE: KARA C LA GRANDE OTR/L
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 Therapist2976CO
2225X00000XOccupational TherapistOT.0002976CO

General Provider Information

NPI Number : 1184103418
Entity Type Code : Individual
Provider Name (Legal Business Name) : KARA C LA GRANDE OTR/L
Provider Business Mailing Address
First Line : 9085 RANCH RIVER CIR
Second Line :
City : HIGHLANDS RANCH
State : CO
Zip : 80126-5094
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 9085 RANCH RIVER CIR
Second Line :
City : HIGHLANDS RANCH
State : CO
Zip : 80126-5094
Country : US
Telephone Number : 720-348-7930
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/08/2018
Last Update Date : 03/06/2022

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Directions to “ KARA C LA GRANDE OTR/L” Practice Location

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