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NPI Code Detail

MEDICARE: MRS. MARLO FORREST STRAWITZ O.T.

MEDICARE: MRS. MARLO FORREST STRAWITZ O.T.
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 Therapist2366NM

General Provider Information

NPI Number : 1770789539
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. MARLO FORREST STRAWITZ O.T.
Provider Business Mailing Address
First Line : 7612 FLORENCE AVE NE
Second Line :
City : ALBUQUERQUE
State : NM
Zip : 87122-3767
Country : US
Telephone Number : 505-821-5594
Fax Number :
Provider Business Practice Location Address
First Line : 8100 PALOMAS AVE NE
Second Line :
City : ALBUQUERQUE
State : NM
Zip : 87109-5264
Country : US
Telephone Number : 505-836-0023
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/26/2007
Last Update Date : 07/08/2007

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