MEDICARE: SUSAN FORTNEY

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	0002668	CO

General Provider Information

NPI Number	:	1578603544
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SUSAN FORTNEY

Provider Business Mailing Address
First Line	:	2361 HUDSON ST
Second Line	:
City	:	DENVER
State	:	CO
Zip	:	80207-3259
Country	:	US
Telephone Number	:	303-547-0811
Fax Number	:

Provider Business Practice Location Address
First Line	:	2361 HUDSON ST
Second Line	:
City	:	DENVER
State	:	CO
Zip	:	80207-3259
Country	:	US
Telephone Number	:	303-547-0811
Fax Number	:

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

Provider Enumeration Date	:	02/07/2007
Last Update Date	:	07/27/2020

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Directions to “ SUSAN FORTNEY ” Practice Location

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