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NPI Code Detail

MEDICARE: CORINNE ALISE PEICK MA, OTR/L

MEDICARE: CORINNE ALISE PEICK MA, 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 Therapist105176MN

General Provider Information

NPI Number : 1427587443
Entity Type Code : Individual
Provider Name (Legal Business Name) : CORINNE ALISE PEICK MA, OTR/L
Provider Business Mailing Address
First Line : 900 W 94TH ST
Second Line :
City : BLOOMINGTON
State : MN
Zip : 55420-4206
Country : US
Telephone Number : 952-885-0418
Fax Number : 952-885-0173
Provider Business Practice Location Address
First Line : 900 W 94TH ST
Second Line :
City : BLOOMINGTON
State : MN
Zip : 55420-4206
Country : US
Telephone Number : 952-885-0418
Fax Number : 952-885-0173
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/05/2017
Last Update Date : 07/21/2022

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