MEDICARE: COLLEEN KAY SPELLMAN OTD, 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	1009	NE

General Provider Information

NPI Number	:	1841485042
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	COLLEEN KAY SPELLMAN OTD, OTR/L

Provider Business Mailing Address
First Line	:	2550 SUPERIOR ST
Second Line	:	SUITE 160
City	:	LINCOLN
State	:	NE
Zip	:	68521-4155
Country	:	US
Telephone Number	:	402-742-7400
Fax Number	:	402-742-9592

Provider Business Practice Location Address
First Line	:	2550 SUPERIOR ST
Second Line	:	SUITE 160
City	:	LINCOLN
State	:	NE
Zip	:	68521-4155
Country	:	US
Telephone Number	:	402-742-7400
Fax Number	:	402-742-9592

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

Provider Enumeration Date	:	09/11/2007
Last Update Date	:	05/19/2009

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