MEDICARE: MRS. GEORGIA E MEYER 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
1	225X00000X	Occupational Therapist	2128 026	WI

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1558566497
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. GEORGIA E MEYER OTR

Provider Business Mailing Address
First Line	:	REHAB IN MOTION
Second Line	:	615 EAST MAIN ST SUITE B
City	:	WATERTOWN
State	:	WI
Zip	:	53094
Country	:	US
Telephone Number	:	920-262-9970
Fax Number	:	920-262-9930

Provider Business Practice Location Address
First Line	:	RAHAB IN MOTION
Second Line	:	615 EAST MAIN ST SUITE B
City	:	WATERTOWN
State	:	WI
Zip	:	53094
Country	:	US
Telephone Number	:	920-262-9970
Fax Number	:	920-262-9950

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

Provider Enumeration Date	:	06/20/2007
Last Update Date	:	07/08/2007

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