MEDICARE: RACHEL KOS OTR/L

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	105849	MN

General Provider Information

NPI Number	:	1649743493
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	RACHEL KOS OTR/L

Provider Business Mailing Address
First Line	:	1068 TICONDEROGA TRL
Second Line	:
City	:	EAGAN
State	:	MN
Zip	:	55123-1526
Country	:	US
Telephone Number	:	651-206-7990
Fax Number	:

Provider Business Practice Location Address
First Line	:	1301 50TH ST E
Second Line	:
City	:	INVER GROVE HEIGHTS
State	:	MN
Zip	:	55077-1250
Country	:	US
Telephone Number	:	651-451-1853
Fax Number	:

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

Provider Enumeration Date	:	01/04/2019
Last Update Date	:	01/04/2019

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Directions to “ RACHEL KOS OTR/L” Practice Location

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