MEDICARE: MARIAN KATHERINE GARTEE MSOTR

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	31003590A	IN

General Provider Information

NPI Number	:	1568618478
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MARIAN KATHERINE GARTEE MSOTR

Provider Business Mailing Address
First Line	:	1220 E JACKSON BLVD
Second Line	:
City	:	ELKHART
State	:	IN
Zip	:	46516-4419
Country	:	US
Telephone Number	:	574-333-9747
Fax Number	:	574-367-2369

Provider Business Practice Location Address
First Line	:	1220 E JACKSON BLVD
Second Line	:
City	:	ELKHART
State	:	IN
Zip	:	46516-4419
Country	:	US
Telephone Number	:	574-333-9747
Fax Number	:	574-367-2369

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

Provider Enumeration Date	:	08/12/2008
Last Update Date	:	03/09/2026

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