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NPI Code Detail

MEDICARE: MEGAN ELIZABETH GRIFFEY MOT, OTR/L

MEDICARE: MEGAN ELIZABETH GRIFFEY MOT, 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
1225X00000XOccupational Therapist056.009278IL

General Provider Information

NPI Number : 1376841429
Entity Type Code : Individual
Provider Name (Legal Business Name) : MEGAN ELIZABETH GRIFFEY MOT, OTR/L
Provider Business Mailing Address
First Line : 25075 HINES RD NE
Second Line :
City : HINES
State : MN
Zip : 56647-4799
Country : US
Telephone Number : 630-659-6092
Fax Number :
Provider Business Practice Location Address
First Line : 425 7TH ST NW
Second Line :
City : CASS LAKE
State : MN
Zip : 56633-3360
Country : US
Telephone Number : 218-335-3200
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/13/2011
Last Update Date : 06/11/2021

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