MEDICARE: JULIANNE LENORA COOPER 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	1047805	CO

General Provider Information

NPI Number	:	1942452727
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JULIANNE LENORA COOPER OTR

Provider Business Mailing Address
First Line	:	300 W 11TH AVE
Second Line	:	UNIT 9G
City	:	DENVER
State	:	CO
Zip	:	80204-3662
Country	:	US
Telephone Number	:	303-596-5447
Fax Number	:

Provider Business Practice Location Address
First Line	:	2480 S CLERMONT ST
Second Line	:
City	:	DENVER
State	:	CO
Zip	:	80222-6512
Country	:	US
Telephone Number	:	303-596-5447
Fax Number	:

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

Provider Enumeration Date	:	10/13/2008
Last Update Date	:	03/16/2009

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