MEDICARE: KERI SIKULA

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	224Z00000X	Occupational Therapy Assistant	513	CO

General Provider Information

NPI Number	:	1497147797
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KERI SIKULA

Provider Business Mailing Address
First Line	:	1112 N ARCADIA ST
Second Line	:
City	:	COLORADO SPRINGS
State	:	CO
Zip	:	80903-2639
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1112 N ARCADIA ST
Second Line	:
City	:	COLORADO SPRINGS
State	:	CO
Zip	:	80903-2639
Country	:	US
Telephone Number	:	303-868-4032
Fax Number	:

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

Provider Enumeration Date	:	02/23/2015
Last Update Date	:	02/23/2015

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Directions to “ KERI SIKULA ” Practice Location

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