MEDICARE: MS. CARRIE LYNNE THOMAS OTR

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	1867	CO

General Provider Information

NPI Number	:	1790911188
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. CARRIE LYNNE THOMAS OTR

Provider Business Mailing Address
First Line	:	1373 DEXTER ST
Second Line	:
City	:	DENVER
State	:	CO
Zip	:	80220-2456
Country	:	US
Telephone Number	:	303-594-1241
Fax Number	:

Provider Business Practice Location Address
First Line	:	1373 DEXTER ST
Second Line	:
City	:	DENVER
State	:	CO
Zip	:	80220-2456
Country	:	US
Telephone Number	:	303-594-1241
Fax Number	:

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

Provider Enumeration Date	:	05/31/2009
Last Update Date	:	06/01/2009

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