MEDICARE: MRS. MARGARET CATHERINE GODFREY OTRL

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	0119003822	VA

General Provider Information

NPI Number	:	1295966463
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. MARGARET CATHERINE GODFREY OTRL

Provider Business Mailing Address
First Line	:	357 ASH ST
Second Line	:
City	:	STRASBURG
State	:	VA
Zip	:	22657-1925
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1 PARK WEST CIR
Second Line	:	SUITE 108
City	:	MIDLOTHIAN
State	:	VA
Zip	:	23114-5551
Country	:	US
Telephone Number	:	800-969-9265
Fax Number	:

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

Provider Enumeration Date	:	08/05/2009
Last Update Date	:	08/05/2009

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