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NPI Code Detail

MEDICARE: TRACY HAND & OCCUPATIONAL THERAPY

MEDICARE: TRACY HAND & OCCUPATIONAL THERAPY
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 Therapist178MT

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
21730394651OTHERMTDME

General Provider Information

NPI Number : 1962593889
Entity Type Code : Organization
Provider Name (Legal Business Name) : TRACY HAND & OCCUPATIONAL THERAPY
Provider Business Mailing Address
First Line : 111 SUNNYVIEW LANE
Second Line : SUITE C
City : KALISPELL
State : MT
Zip : 59901-3164
Country : US
Telephone Number : 406-752-7581
Fax Number : 406-752-7584
Provider Business Practice Location Address
First Line : 111 SUNNYVIEW LANE
Second Line : SUITE C
City : KALISPELL
State : MT
Zip : 59901-3164
Country : US
Telephone Number : 406-752-7581
Fax Number : 406-752-7584
Authorized Official
Title or Position : OWNER
Name : MR. TIMOTHY MICHAEL TRACY
Credential : OTR CHT
Telephone Number : 406-752-7581
Provider Enumeration Date : 09/27/2006
Last Update Date : 05/21/2016

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Directions to “TRACY HAND & OCCUPATIONAL THERAPY ” Practice Location

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