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NPI Code Detail

MEDICARE: MS. KARLA ANN CHACE OTR

MEDICARE: MS. KARLA ANN CHACE 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 Therapist1579NM

General Provider Information

NPI Number : 1386840916
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. KARLA ANN CHACE OTR
Provider Business Mailing Address
First Line : 1920 HIGHLAND AVE
Second Line :
City : DURANGO
State : CO
Zip : 81301-4851
Country : US
Telephone Number : 970-759-2451
Fax Number :
Provider Business Practice Location Address
First Line : 800 SAGUARO TRL
Second Line :
City : FARMINGTON
State : NM
Zip : 87401-9632
Country : US
Telephone Number : 505-598-6000
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/21/2007
Last Update Date : 07/08/2007

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