MEDICARE: HELEN R. WOOLLEY OT

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	687	MT

General Provider Information

NPI Number	:	1679749089
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	HELEN R. WOOLLEY OT

Provider Business Mailing Address
First Line	:	600 FIRST AVENUE NORTH
Second Line	:
City	:	HOT SPRINGS
State	:	MT
Zip	:	59845
Country	:	US
Telephone Number	:	406-741-2992
Fax Number	:	406-741-2994

Provider Business Practice Location Address
First Line	:	600 FIRST AVENUE NORTH
Second Line	:
City	:	HOT SPRINGS
State	:	MT
Zip	:	59845
Country	:	US
Telephone Number	:	406-741-2992
Fax Number	:	406-741-2994

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

Provider Enumeration Date	:	05/06/2008
Last Update Date	:	05/06/2008

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