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NPI Code Detail

MEDICARE: BETSY A JOHNSON OTR

MEDICARE: BETSY A JOHNSON OTR
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 Therapist3136-026WI

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1316130479
Entity Type Code : Individual
Provider Name (Legal Business Name) : BETSY A JOHNSON OTR
Provider Business Mailing Address
First Line : 407 N 8TH ST
Second Line :
City : MOUNT HOREB
State : WI
Zip : 53572-1872
Country : US
Telephone Number : 608-437-9626
Fax Number :
Provider Business Practice Location Address
First Line : 407 N 8TH ST
Second Line :
City : MOUNT HOREB
State : WI
Zip : 53572-1872
Country : US
Telephone Number : 608-437-9626
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/22/2007
Last Update Date : 06/06/2013

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