MEDICARE: JESSICA RAE TORCZON 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	2145	NE

General Provider Information

NPI Number	:	1366147720
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JESSICA RAE TORCZON OTR/L

Provider Business Mailing Address
First Line	:	10809 S 186TH AVE
Second Line	:
City	:	OMAHA
State	:	NE
Zip	:	68136-6426
Country	:	US
Telephone Number	:	402-208-1835
Fax Number	:

Provider Business Practice Location Address
First Line	:	10809 S 186TH AVE
Second Line	:
City	:	OMAHA
State	:	NE
Zip	:	68136-6426
Country	:	US
Telephone Number	:	402-208-1835
Fax Number	:

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

Provider Enumeration Date	:	04/04/2023
Last Update Date	:	04/04/2023

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Directions to “ JESSICA RAE TORCZON OTR/L” Practice Location

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