MEDICARE: DOUGLAS K BARRIENTOS 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
1	225X00000X	Occupational Therapist	1225	NE

General Provider Information

NPI Number	:	1275864951
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DOUGLAS K BARRIENTOS OTR-L

Provider Business Mailing Address
First Line	:	6504 S 108TH AVE
Second Line	:
City	:	OMAHA
State	:	NE
Zip	:	68137-4713
Country	:	US
Telephone Number	:	402-871-9349
Fax Number	:

Provider Business Practice Location Address
First Line	:	655 CRAIG RD STE 150
Second Line	:
City	:	SAINT LOUIS
State	:	MO
Zip	:	63141-7173
Country	:	US
Telephone Number	:	888-262-6966
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/20/2010
Last Update Date	:	01/20/2010

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