MEDICARE: DOVER-EYOTA 533

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
1	251300000X	Local Education Agency (LEA)

General Provider Information

NPI Number	:	1205978137
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	DOVER-EYOTA 533

Provider Business Mailing Address
First Line	:	615 SOUTH AVENE SE
Second Line	:
City	:	EYOTA
State	:	MN
Zip	:	55984-9777
Country	:	US
Telephone Number	:	507-545-2631
Fax Number	:

Provider Business Practice Location Address
First Line	:	615 SOUTH AVE SE
Second Line	:
City	:	EYOTA
State	:	MN
Zip	:	55984-9777
Country	:	US
Telephone Number	:	507-545-2631
Fax Number	:

Authorized Official
Title or Position	:	DIRECTOR, SPECIAL EDUCATION
Name	:	AMY ADAMS
Credential	:
Telephone Number	:	507-767-3339

Provider Enumeration Date	:	02/14/2007
Last Update Date	:	08/22/2020

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