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NPI Code Detail

MEDICARE: MR. WILLIAM G WESTERGARD MAOTR

MEDICARE: MR. WILLIAM G WESTERGARD MAOTR
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 Therapist
2225XG0600XGerontology Occupational Therapist

General Provider Information

NPI Number : 1588956841
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. WILLIAM G WESTERGARD MAOTR
Provider Business Mailing Address
First Line : 29571 FAIRWAY DR
Second Line :
City : EVERGREEN
State : CO
Zip : 80439-7460
Country : US
Telephone Number : 720-261-1205
Fax Number : 303-320-3533
Provider Business Practice Location Address
First Line : 333 S EATON ST
Second Line :
City : LAKEWOOD
State : CO
Zip : 80226-3544
Country : US
Telephone Number : 303-935-1448
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/05/2011
Last Update Date : 05/05/2011

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