MEDICARE: KATHERINE PERRINE

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

General Provider Information

NPI Number	:	1669984456
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KATHERINE PERRINE

Provider Business Mailing Address
First Line	:	2608 KANSAS DR APT I-158
Second Line	:
City	:	FORT COLLINS
State	:	CO
Zip	:	80525-7657
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	2608 KANSAS DR APT I-158
Second Line	:
City	:	FORT COLLINS
State	:	CO
Zip	:	80525-7657
Country	:	US
Telephone Number	:	773-218-4265
Fax Number	:

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

Provider Enumeration Date	:	11/01/2017
Last Update Date	:	11/01/2017

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Directions to “ KATHERINE PERRINE ” Practice Location

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