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NPI Code Detail

MEDICARE: SUE JEAN CHUNG O.T.R.

MEDICARE: SUE JEAN CHUNG O.T.R.
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 TherapistOTR0003561CO

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1OTR0003561OTHERCONPI

General Provider Information

NPI Number : 1255776043
Entity Type Code : Individual
Provider Name (Legal Business Name) : SUE JEAN CHUNG O.T.R.
Provider Business Mailing Address
First Line : 7481 KNOX PL
Second Line :
City : WESTMINSTER
State : CO
Zip : 80030-4818
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 7481 KNOX PL
Second Line :
City : WESTMINSTER
State : CO
Zip : 80030-4818
Country : US
Telephone Number : 303-427-7101
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/07/2013
Last Update Date : 05/07/2013

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