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NPI Code Detail

MEDICARE: MRS. KRISTIN RENEE OVENSHIRE MOREHOUSE MSOT. MED

MEDICARE: MRS. KRISTIN RENEE OVENSHIRE MOREHOUSE MSOT. MED
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 TherapistOT 2500CO

General Provider Information

NPI Number : 1306161146
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. KRISTIN RENEE OVENSHIRE MOREHOUSE MSOT. MED
Provider Business Mailing Address
First Line : PO BOX 4790
Second Line :
City : PAGOSA SPRINGS
State : CO
Zip : 81157-4790
Country : US
Telephone Number : 970-264-6778
Fax Number :
Provider Business Practice Location Address
First Line : 119 BASTILLE DR
Second Line :
City : PAGOSA SPRINGS
State : CO
Zip : 81147-9388
Country : US
Telephone Number : 970-731-4041
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/05/2010
Last Update Date : 04/05/2010

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